Individual
KACEE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
110 N DREW ST, STAR CITY, AR 71667-5704
(870) 628-5110
(855) 854-6281
Mailing address
PO BOX 509, DERMOTT, AR 71638-0509
(870) 538-5414
(870) 538-5412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
213443
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236266758
—
AR
Enumeration date
10/06/2021
Last updated
02/21/2023
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