Individual
KAYLEE KEENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4305 S PLEASANT CROSSING BLVD STE 3, ROGERS, AR 72758-1495
(479) 278-7414
(479) 278-7157
Mailing address
1222 W POPLAR ST, ROGERS, AR 72756-4246
(501) 441-6522
(479) 337-5302
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4823
OK
363A00000X
Physician Assistant
Primary
PA-930
AR
363A00000X
Physician Assistant
PA13490
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1F5971
MEDICARE
TX
05
—
200911220A
—
OK
05
—
410600702
—
TX
01
—
P02599441
MCRR
TX
Enumeration date
02/17/2019
Last updated
08/27/2025
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