Individual
KIMBERLY T. MACCONAUGHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202
(501) 364-1100
(501) 526-6562
Mailing address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202-3500
(501) 364-1100
(501) 526-6562
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A03713
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A03713
APN
AR
Enumeration date
06/13/2012
Last updated
03/26/2021
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