Michele R Kilmer, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

A03324 Issued in AR

Practice address

5203 Willow Creek Dr
Springdale, AR 72762-0876

Phone

(479) 251-8000

Fax

(479) 444-6856

NPI assigned

Sep 18, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1083863609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3794 ROCK SPRINGS ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628892",
            "telephone_number": "479-756-0980",
            "fax_number": "479-756-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 WILLOW CREEK DR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620876",
            "telephone_number": "479-251-8000",
            "fax_number": "479-444-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILMER",
        "first_name": "MICHELE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "632703",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A03324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimlor Medical Supply

• All providers in Springdale, AR
• Pediatric Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.