Healthcare Provider Details

I. General information

NPI: 1609285527
Provider Name (Legal Business Name): KATHRYN E PLEDGER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 DETROIT AVE
DANVILLE AR
72833-9607
US

IV. Provider business mailing address

1500 DODSON AVE STE 230
FORT SMITH AR
72901-5179
US

V. Phone/Fax

Practice location:
  • Phone: 479-495-6270
  • Fax: 479-495-6299
Mailing address:
  • Phone: 479-709-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberA004150
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: