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Individual

KIMBERLY L HERTLEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
303 S 5TH ST, PARIS, AR 72855-4501
(479) 963-2132
(479) 963-2046
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01805
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080017768
RR MEDICARE
05
157386758
AR
Enumeration date
08/25/2006
Last updated
08/28/2015
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