Individual
KACY V. ENLOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1695 E RAINFOREST RD, FAYETTEVILLE, AR 72703-5385
(479) 445-6460
Mailing address
1695 E RAINFOREST RD, FAYETTEVILLE, AR 72703-5385
(479) 651-1194
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3503
TN
363A00000X
Physician Assistant
Primary
979
AR
Other
Enumeration date
08/30/2018
Last updated
05/24/2021
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