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General NPI Number Information
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NPI Number | 1083863609
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Entity Type | Individual
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Provider Name | MICHELE R KILMER PNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 5203 WILLOW CREEK DR
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City | SPRINGDALE
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State | AR
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Zip | 72762-0876
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Country | US
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Telephone | 479-251-8000
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Fax | 479-444-6856
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Provider Business Mailing Address
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Address Line | 3794 ROCK SPRINGS ST
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City | SPRINGDALE
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State | AR
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Zip | 72762-8892
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Country | US
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Telephone | 479-756-0980
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Fax | 479-756-0980
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 632703
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A03324
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License Number State | AR
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