MEDICARE: KYMBERLY ROBIN AMYETT APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	A03241	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760784771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYMBERLY ROBIN AMYETT APN

Provider Business Mailing Address
First Line	:	14309 CANTRELL RD
Second Line	:	#7
City	:	LITTLE ROCK
State	:	AR
Zip	:	72223-4217
Country	:	US
Telephone Number	:	501-224-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	14309 CANTRELL RD
Second Line	:	#7
City	:	LITTLE ROCK
State	:	AR
Zip	:	72223-4217
Country	:	US
Telephone Number	:	501-224-6727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2010
Last Update Date	:	04/22/2015

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