Healthcare Provider Details

I. General information

NPI: 1598219263
Provider Name (Legal Business Name): MRS. KELSEY EVELYN PILLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KELSEY EVELYN GREGORY

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HWY 65 NORTH SUITE 200
HARRISON AR
72601-2236
US

IV. Provider business mailing address

PO BOX 802843
KANSAS CITY MO
64180-2843
US

V. Phone/Fax

Practice location:
  • Phone: 707-439-7448
  • Fax: 870-743-9746
Mailing address:
  • Phone: 417-730-6430
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004874
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022002855
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: