Healthcare Provider Details
I. General information
NPI: 1770471690
Provider Name (Legal Business Name): KINCADE HEALTH MANAGEMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E MTN SPRINGS RD
CABOT AR
72023-2493
US
IV. Provider business mailing address
1 KINCADE LN
CABOT AR
72023-7179
US
V. Phone/Fax
- Phone: 501-286-7720
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
KINCADE
Title or Position: OWNER
Credential: APRN
Phone: 501-743-9021