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General NPI Number Information
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NPI Number | 1003406653
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Entity Type | Individual
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Provider Name | MELISSA S KEESEE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 213 CABLE LN
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City | BISMARCK
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State | AR
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Zip | 71929-8900
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Country | US
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Telephone | 501-318-3120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1011
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City | HOPE
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State | AR
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Zip | 71802-1011
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Country | US
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Telephone | 870-777-2429
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 213224
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 213224
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License Number State | AR
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