Individual
LACEY DESHAY KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
7509 RED PINE DR, FORT SMITH, AR 72916-8809
(479) 414-9629
Mailing address
7509 RED PINE DR, FORT SMITH, AR 72916-8809
(479) 414-9629
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06201581
AR
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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