Healthcare Provider Details

I. General information

NPI: 1942711783
Provider Name (Legal Business Name): KEECHIA GEAN MUSE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEECHIA MOTES APRN

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 HIGHWAY 463 N
TRUMANN AR
72472-3501
US

IV. Provider business mailing address

143 HIGHWAY 463 N
TRUMANN AR
72472-3501
US

V. Phone/Fax

Practice location:
  • Phone: 870-650-4703
  • Fax: 949-909-7938
Mailing address:
  • Phone: 870-650-4703
  • Fax: 949-909-7938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberS002321
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number221657
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: