Healthcare Provider Details

I. General information

NPI: 1427975044
Provider Name (Legal Business Name): KATHRYN BURROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS WAY
LITTLE ROCK AR
72202-3500
US

IV. Provider business mailing address

6017 LAGUNA IMPALA
MABELVALE AR
72103-3456
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1100
  • Fax:
Mailing address:
  • Phone: 501-240-8668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number121105
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: