Provider Demographics
NPI:1710091988
Name:KIRKPATRICK, CHAUNA K (APN)
Entity Type:Individual
Prefix:
First Name:CHAUNA
Middle Name:K
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 N. NORTH HILLS BLVD.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-571-4338
Mailing Address - Fax:479-571-4015
Practice Address - Street 1:3211 N. NORTH HILLS BLVD.
Practice Address - Street 2:SUITE 110
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-571-4338
Practice Address - Fax:479-571-4015
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01504363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARR50641OtherRN
AR347371OtherANCC
ARA01504OtherAPN
ARP01727OtherRNP
ARMT0640195OtherDEA
AR5U613Medicare ID - Type Unspecified