MS. KELLEY L EASLEY DOTSON APN PNP-BC NPI 1902064272

NPI Information

  • NPI: 1902064272
  • Provider Name: MS. KELLEY L EASLEY DOTSON, APN PNP-BC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1102 CRESTWOOD CIR
    MENA, AR
    ZIP 71953
  • Phone: (479) 394-7301

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NPI Details

MS. Kelley L Easley Dotson, APN PNP-BC is a pediatrics nurse practitioner in Mena, AR. MS. Kelley L Easley Dotson, APN PNP-BC NPI is 1902064272. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1102 CRESTWOOD CIR
MENA, AR
ZIP 71953-513
Phone: (479) 394-7301
Fax: (479) 394-0371

The NPI 1902064272 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/23/2008 and was last updated on 6/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareA001612ARKANSASNo
2363LP0200XNurse PractitionerPediatricsA001612ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1178404758MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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