Healthcare Provider Details

I. General information

NPI: 1417879412
Provider Name (Legal Business Name): CARLA KEELING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 STATE HIGHWAY 7 N
DARDANELLE AR
72834-8170
US

IV. Provider business mailing address

2306 STATE HIGHWAY 7 N
DARDANELLE AR
72834-8170
US

V. Phone/Fax

Practice location:
  • Phone: 479-858-9049
  • Fax:
Mailing address:
  • Phone: 479-229-4550
  • Fax: 479-229-1697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR52147
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: