Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 213224 | AR |
N | 363LP2300X | Nurse Practitioner - Primary Care | 213224 | AR |
NPI | 1003406653 |
---|---|
Provider Name | Melissa S Keesee |
First Address | Hope, AR 71802-1011 |
Second Address | Bismarck, AR 71929-8900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2021 |
Last Update Date | 18/01/2021 |