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General NPI Number Information
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NPI Number | 1003635392
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Entity Type | Individual
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Provider Name | KIMBERLY MONIQUE MARKS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 524 CARPENTER DAM RD
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8213
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Country | US
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Telephone | 501-262-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 120 HIDDEN VALLEY LOOP
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City | MAUMELLE
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State | AR
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Zip | 72113-6781
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Country | US
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Telephone | 903-276-7285
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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 | 214213
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License Number State | AR
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