KELLIE ANN CHACANACA (NPI# 1487004461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487004461 |
| Entity Type | Individual |
| Full Name | KELLIE ANN CHACANACA |
| Credential | APRN |
| Practice Address |
325 S 6th Pl Lowell AR 72745 |
| Mailing Address |
325 S 6th Pl Lowell AR 72745-9704 |
| Practice Telephone | 4797700700 |
| Practice Fax Number | 4797701184 |
| Mailing Telephone | 4797700700 |
| Mailing Fax Number | 4797701184 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2019-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A004753 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 613 N 2nd St, Rogers, AR 727566611 | 4798781030 | 4798781070 |
| Street Address |
325 S 6TH PL |
| City | LOWELL |
| State | AR |
| Zip Code | 72745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205832219 | Cheryl A Fulton | Family Medicine | 325 S 6th Pl, Lowell, AR 72745-9704 | 2005-06-23 |
| 1518410919 | Jason Traxson | Specialist | 325 S 6th Pl, Lowell, AR 72745-9704 | 2016-08-02 |
| 1164740452 | Blake D Bryant | Family Medicine | 325 S 6th Pl, Lowell, AR 72745-9704 | 2010-05-11 |
| 1407084320 | Adegbenga Ademuyiwa Olayemi | Pediatrics | 325 S 6th Pl, Lowell, AR 72745-9704 | 2009-06-30 |
| 1578690756 | Judith Grace Fetters | Nurse Practitioner | 325 S 6th Pl, Lowell, AR 72745-9704 | 2007-02-27 |
| 1205972130 | Diane Denice Erickson | Social Worker | 325 S 6th Pl, Lowell, AR 72745-9704 | 2007-01-29 |
| 1952357394 | William Wiley Jones Jr. | Psychologist | 325 S 6th Pl, Lowell, AR 72745-9704 | 2006-05-26 |
| 1194773861 | Thomas Hunter Youngblood | Pediatrics | 325 S 6th Pl, Lowell, AR 72745-9704 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518442706 | Harps Food Stores, Inc. | Pharmacy | 916 W Monroe Ave., Lowell, AR 72745 | 2018-10-03 |
| 1801300405 | Sarah Elizabeth Bright | Speech-Language Pathologist | 121 South Ave., Lowell, AR 72745 | 2017-11-20 |
| 1306398151 | Keegan Sutton | Occupational Therapist | 612 S Lincoln, Ste A, Lowell, AR 72745 | 2016-10-27 |
| 1922470368 | Sharon Hunter | Contractor | 14213 Edens Bluff Drive, Lowell, AR 72745 | 2015-10-26 |
| 1881959450 | Robert J. Tomlinson Md, Pa | Orthopaedic Surgery | 212 W. Monroe Ave., Ste A, Lowell, AR 72745 | 2012-07-10 |
| 1376806760 | Gretchen E Brannon | Nurse Practitioner | 114 Harrison Ave., Lowell Pharmacy Blds, Lowell, AR 72745 | 2012-06-20 |
| 1407094220 | Dr. Angela Moore Family Chiropractic, P.l.c. | Chiropractor | 117 S Dixieland St, Ste B, Lowell, AR 72745 | 2009-02-02 |
| 1104078302 | University of Arkansas for Medical Science | Developmental Therapist | 519 Latham Dr., Lowell, AR 72745 | 2008-10-21 |
| 1356593479 | University of Arkansas for Medical Sciences | Registered Nurse | 519 Latham Drive, Lowell, AR 72745 | 2008-10-21 |
| 1912039827 | Looper Chiropractic Pa | Chiropractor | 200 S Bloomington, Ste I, Lowell, AR 72745 | 2007-03-09 |
| Find all providers in zip 72745 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679187207 | Laura Jeannine Neal | Nurse Practitioner | 11399 Kelly Ln, Lowell, AR 72745-8643 | 2020-09-01 |
| 1578184693 | Desiree Lynn Hilborn | Nurse Practitioner | 638 Creekside Dr Apt 208, Lowell, IN 46356-7911 | 2020-04-29 |
| 1730741158 | Kenna Lea Wagner | Nurse Practitioner | 60 Lock St, Lowell, OH 45744-9023 | 2019-07-05 |
| 1184280091 | Joyce Gichana | Nurse Practitioner | 1001 Westford St Apt 14, Lowell, MA 01851-2741 | 2019-05-15 |
| 1760956536 | Melanie Burgess Dumont | Nurse Practitioner | 71 Jackson St Unit 313, Lowell, MA 01852-2178 | 2019-01-15 |
| 1992277214 | Jody Huck | Nurse Practitioner | 4010 Rainbow Rd, Lowell, OH 45744-7176 | 2018-12-27 |
| 1477077295 | Melissa Rose Stewart | Nurse Practitioner | 15896 Cow Face Rd, Lowell, AR 72745-9158 | 2017-08-02 |
| 1174071286 | Ruth Walsworth | Nurse Practitioner | 595 Pawtucket Blvd Ste 2, Lowell, MA 01854-2042 | 2016-09-18 |
| 1750634531 | Jill Irene Maddack | Nurse Practitioner | 4500 W 181st Ave, Lowell, IN 46356-0017 | 2012-10-18 |
| 1376806760 | Gretchen E Brannon | Nurse Practitioner | 114 Harrison Ave., Lowell Pharmacy Blds, Lowell, AR 72745 | 2012-06-20 |
| Find all providers in LOWELL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.