Healthcare Provider Details

I. General information

NPI: 1477464980
Provider Name (Legal Business Name): KIANNA WALKER APRN
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: KIANNA CANADY

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 OUTPATIENT CIRCLE
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7199
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-6086
  • Fax: 501-526-5148
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number239216
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: