Healthcare Provider Details

I. General information

NPI: 1235043258
Provider Name (Legal Business Name): KERRIGAN GUIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

4070 HAMPTON DR
BENTON AR
72019-7045
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5224
  • Fax:
Mailing address:
  • Phone: 318-734-7021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number124068
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: