Provider Demographics
NPI:1053835215
Name:KLINEFELTER, KIMBERLY ANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:KLINEFELTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W PLEASANT GROVE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-7034
Mailing Address - Country:US
Mailing Address - Phone:479-326-8525
Mailing Address - Fax:479-202-5010
Practice Address - Street 1:2301 W PLEASANT GROVE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-7034
Practice Address - Country:US
Practice Address - Phone:479-326-8525
Practice Address - Fax:479-202-5010
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH076342-23363LF0000X
AR213394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily