Healthcare Provider Details

I. General information

NPI: 1760317705
Provider Name (Legal Business Name): KAYLEE NEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 NEIL DR
JONESBORO AR
72401-4462
US

IV. Provider business mailing address

2705 EDEN RD
BENTON AR
72015-4797
US

V. Phone/Fax

Practice location:
  • Phone: 501-626-4028
  • Fax:
Mailing address:
  • Phone: 501-626-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number125737
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: