KELLIE NICOLE UNDERWOOD

ROGERS, AR
NPI1154925824
Former NameKELLIE NICOLE BUCKNER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: AR  122078)
Enumeration Date2020-11-24
Last Update Date2020-11-24
Business Address
KELLIE NICOLE UNDERWOOD
3307 N DIXIELAND RD
ROGERS, AR 72756-6816
Phone number: 479-986-5150
Mailing Address
KELLIE NICOLE UNDERWOOD
PO BOX 130
ROGERS, AR 72757-0130
Phone number: 479-986-5150
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