Healthcare Provider Details

I. General information

NPI: 1932963386
Provider Name (Legal Business Name): MCKINSEA DAWN PATEL APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 EMILY DR
MOUNTAIN VIEW AR
72560-7972
US

IV. Provider business mailing address

102 EMILY DR
MOUNTAIN VIEW AR
72560-7972
US

V. Phone/Fax

Practice location:
  • Phone: 870-656-0219
  • Fax:
Mailing address:
  • Phone: 870-656-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number120197
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: