Individual
KELLY R. MCCARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5872 W BANNISTER DR, FAYETTEVILLE, AR 72704-6536
(479) 276-0939
Mailing address
5872 W BANNISTER DR, FAYETTEVILLE, AR 72704-6536
(479) 276-0939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
123726
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
123726
AR
363LP2300X
Primary Care Nurse Practitioner
123726
AR
Other
Enumeration date
05/06/2020
Last updated
08/04/2024
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