Individual
MS. KELLEY L EASLEY DOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN PNP-BC
Contact information
Practice address
1102 CRESTWOOD CIR, MENA, AR 71953-5513
(479) 394-7301
(479) 394-0371
Mailing address
PO BOX 251418, LITTLE ROCK, AR 72225-1418
(501) 364-1100
(501) 364-4082
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A001612
AR
363LP2300X
Primary Care Nurse Practitioner
A001612
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178404758
—
AR
Enumeration date
05/23/2008
Last updated
06/13/2024
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