Individual
MRS. KELLIE LYNN LISENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MNSC, CPNP
Contact information
Practice address
1 CHILDRENS WAY, SLOT 837, LITTLE ROCK, AR 72202-3500
(501) 364-4468
(501) 364-1516
Mailing address
1 CHILDRENS WAY, SLOT 837, LITTLE ROCK, AR 72202-3500
(501) 364-4468
(501) 364-1516
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A03042
AR
Other
Enumeration date
09/24/2007
Last updated
02/15/2011
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