Individual
ANITA MARIE KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5221
(479) 787-5613
Mailing address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5221
(479) 787-5613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
20020220211
MO
363L00000X
Nurse Practitioner
Primary
A01738
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265490916
GROUP NPI NUMBER
AR
05
—
150836758
—
AR
Enumeration date
05/05/2006
Last updated
10/16/2023
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