MEDICARE: MRS. KATHY ANN SWEENEY MHPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	171M00000X	AR

General Provider Information

NPI Number	:	1437271475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY ANN SWEENEY MHPP

Provider Business Mailing Address
First Line	:	2 INNWOOD CIR
Second Line	:	SUITE A
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-2447
Country	:	US
Telephone Number	:	501-954-7470
Fax Number	:	501-954-7420

Provider Business Practice Location Address
First Line	:	2 INNWOOD CIR
Second Line	:	SUITE A
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-2447
Country	:	US
Telephone Number	:	501-954-7470
Fax Number	:	501-954-7420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/08/2007

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