Lueders, Kelly Ann

Lueders, Kelly Ann is an individual health care provider with primary practice located at 2110 W Walnut St , Rogers AR 72756-3246. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Lueders, Kelly Ann can be contacted via phone (479) 202-7035.

Contact Information

Primary practice address
2110 W Walnut St Rogers AR 72756-3246
Phone: (479) 202-7035
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1191 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-443 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-443 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2009009834 Missouri

Profile Details

NPI number 1730135922
LBN Legal business name Lueders, Kelly Ann
Credentials DMS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Jun 26th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730135922 NPPES
Oklahoma MEDICAID 100768880I
Oklahoma MEDICAID 100768880J
Oklahoma Other 5V349

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