Provider Demographics
NPI:1841804945
Name:HERRINGTON, MADELINE KENNEDY (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:KENNEDY
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:KENNEDY
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:900 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BRINKLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72021-3514
Mailing Address - Country:US
Mailing Address - Phone:870-270-7087
Mailing Address - Fax:
Practice Address - Street 1:921 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-9183
Practice Address - Country:US
Practice Address - Phone:870-633-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR212920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily