Healthcare Provider Details

I. General information

NPI: 1467304832
Provider Name (Legal Business Name): TAYLOR MCKENZIE CARDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5921 RILEY PARK DR
FORT SMITH AR
72916-6103
US

IV. Provider business mailing address

5921 RILEY PARK DR
FORT SMITH AR
72916-6103
US

V. Phone/Fax

Practice location:
  • Phone: 479-649-3376
  • Fax: 479-242-2256
Mailing address:
  • Phone: 479-649-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number223248
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: