Provider Demographics
NPI:1477050110
Name:MURACH, KYNDAL RILEY (APRN)
Entity Type:Individual
Prefix:
First Name:KYNDAL
Middle Name:RILEY
Last Name:MURACH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KYNDAL
Other - Middle Name:TAYLOR
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 9178
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-9178
Mailing Address - Country:US
Mailing Address - Phone:855-498-6767
Mailing Address - Fax:479-968-1673
Practice Address - Street 1:200 RIVER MARKET AVE STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-1770
Practice Address - Country:US
Practice Address - Phone:501-492-0099
Practice Address - Fax:479-968-1673
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012209363LA2100X
AR216032363LA2200X
AR216302363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health