Individual
MS. STACY ANN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.
Contact information
Practice address
3 MEDICAL PLZ, MOUNTAIN HOME, AR 72653-2918
(870) 424-3400
(870) 424-4121
Mailing address
3 MEDICAL PLZ, MOUNTAIN HOME, AR 72653-2918
(870) 424-3400
(870) 424-4121
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A003832
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SV086
BCBS
AR
Enumeration date
02/15/2006
Last updated
03/07/2023
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