Provider Demographics
NPI:1952805368
Name:FREEMAN, KAYLA E (CNP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:E
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:E
Other - Last Name:MCKANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0845
Practice Address - Country:US
Practice Address - Phone:479-725-6800
Practice Address - Fax:479-725-6582
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKM110189363LP0200X
ARA005572363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics