Individual
KEENA MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
Mailing address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3395
(479) 968-2345
(479) 890-2467
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R093441
AR
363LF0000X
Family Nurse Practitioner
Primary
A005952
AR
Other
Enumeration date
07/07/2015
Last updated
01/29/2020
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