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General NPI Number Information
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NPI Number | 1285893552
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Entity Type | Individual
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Provider Name | CAROLE LEE MACKEY APN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 3600 CANTRELL RD STE 205 SLOT 512-33
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City | LITTLE ROCK
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State | AR
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Zip | 72202-1893
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Country | US
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Telephone | 501-526-8027
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Fax | 501-526-8014
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Provider Business Mailing Address
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Address Line | 20 ARCADIA CIR
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City | BRYANT
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State | AR
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Zip | 72022-3102
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Country | US
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Telephone | 501-847-6468
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A01903ANP
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License Number State | AR
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