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KELLIE NICHOLE ROBERTSON MSN NP-C NPI 1922278878


NPI Information

NPI: 1922278878
Provider Name: KELLIE NICHOLE ROBERTSON, MSN, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
3344 N FUTRALL DR
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 582-7395
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Kellie Nichole Robertson, MSN, NP-C is a family nurse practitioner in Fayetteville, AR with 17 years of experience. Kellie Nichole Robertson, MSN, NP-C NPI is 1922278878. 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:

3344 N FUTRALL DR
FAYETTEVILLE, AR
ZIP 72703-057
Phone: (479) 582-7395
Fax: (479) 582-7310

The NPI 1922278878 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)

The enumeration date for this NPI number is 3/6/2008 and was last updated on 11/6/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyA03078 ANPARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1175580758MEDICAIDARKANSAS
25A9906658MEDICARE PINARKANSAS
35A990OTHERARKANSASMEDICARE
4200241820AMEDICAIDOKLAHOMA
55A990OTHERARKANSASAR BCBS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.