Individual
KELLY A TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-2467
Mailing address
101 SKYLINE DRIVE, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-2467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A03661
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191897758
—
AR
Enumeration date
03/21/2012
Last updated
08/22/2023
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