Ms Maryalice Kelly, APN | |
1125 N College Ave, Fayetteville, AR 72703-1908 | |
(479) 713-8000 | |
(479) 443-3903 |
Full Name | Ms Maryalice Kelly |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 1125 N College Ave, Fayetteville, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326071283 | NPI | - | NPPES |
182728758 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | A001933 (Arkansas) | Primary |
Entity Name | Northwest Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194768721 PECOS PAC ID: 0244213213 Enrollment ID: O20040610000882 |
Mailing Address | Practice Location Address |
---|---|
Ms Maryalice Kelly, APN Po Box 251420, Little Rock, AR 72225-1420 Ph: (501) 686-8000 | Ms Maryalice Kelly, APN 1125 N College Ave, Fayetteville, AR 72703-1908 Ph: (479) 713-8000 |
Michele L Griffin, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 641-780-8696 | |
Durinda Pena, A.P.N. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3232 N North Hills Blvd., Fayetteville, AR 72703 Phone: 479-587-1700 Fax: 479-587-1366 | |
Mrs. Diane H. Morrow, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2630 E Citizens Dr Ste 13, Fayetteville, AR 72703 Phone: 479-571-6000 | |
Colby Hines, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 479-443-4301 | |
Elizabeth Ann-grace Burns, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3344 N Futrall Dr, Fayetteville, AR 72703 Phone: 479-521-8200 Fax: 479-582-7329 | |
Julia Marsh, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 180 E Sunbridge Dr, Fayetteville, AR 72703 Phone: 479-587-5805 Fax: 479-659-7930 | |
Miss Sarah Anne Campbell, DNP, AGAC-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3211 N Northhills Blvd, Fayetteville, AR 72703 Phone: 479-463-8740 |