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Individual

KELLIE ANN CHACANACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3623 JOHNSON MILL BLVD STE 101, SPRINGDALE, AR 72762-6412
(479) 575-9359
Mailing address
8300 LA SCALA AVE, SPRINGDALE, AR 72762-4278

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004753
AR

Other

Enumeration date
06/21/2016
Last updated
03/12/2025
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