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General NPI Number Information
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NPI Number | 1710443544
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Entity Type | Individual
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Provider Name | KAYLEE KEENER PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/17/2019
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 4305 S PLEASANT CROSSING BLVD STE 3
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City | ROGERS
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State | AR
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Zip | 72758-1495
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Country | US
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Telephone | 479-278-7414
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Fax | 479-278-7157
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Provider Business Mailing Address
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Address Line | 1222 W POPLAR ST
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City | ROGERS
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State | AR
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Zip | 72756-4246
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Country | US
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Telephone | 501-441-6522
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Fax | 479-337-5302
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13490
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4823
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-930
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License Number State | AR
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