Individual
ROSINE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-5175
Mailing address
PO BOX 776075, CHICAGO, IL 60677-6075
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AC00390
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207090758
—
AR
Enumeration date
04/09/2008
Last updated
05/01/2017
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