Traylor, Kelly A
Traylor, Kelly A is an individual health care provider with primary practice located at 101 Skyline Dr , Russellville AR 72801-3363. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Traylor, Kelly A can be contacted via phone (479) 968-2345.Contact Information
Primary practice address
101 Skyline Dr
Russellville AR 72801-3363
Phone: (479) 968-2345
Fax: (479) 890-2467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A03661 | Arkansas |
Profile Details
| NPI number | 1629343868 |
|---|---|
| LBN Legal business name | Traylor, Kelly A |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2012 |
| Last updated | Aug 22nd, 2023 - about 2 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629343868 | NPPES |
| Arkansas | MEDICAID | 191897758 |
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