Healthcare Provider Details

I. General information

NPI: 1710892286
Provider Name (Legal Business Name): HEATHER KAZY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 N 50TH ST
FORT SMITH AR
72904-5719
US

IV. Provider business mailing address

620 LAUREL DR
GREENWOOD AR
72936-5711
US

V. Phone/Fax

Practice location:
  • Phone: 479-785-2451
  • Fax: 479-784-8177
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR080105
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: