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General NPI Number Information
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NPI Number | 1124902002
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Entity Type | Individual
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Provider Name | KINSEY BROOKE LY APRN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-1244
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PONTALBA DR
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City | LITTLE ROCK
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State | AR
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Zip | 72211-2128
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Country | US
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Telephone | 870-416-8798
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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 | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | PENDING
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License Number State | AR
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