Kenneth Chinchilla, PMHNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Cabot, AR

NPI 1376368332 · NPPES record last updated Jul 9, 2026

Key facts

NPI
1376368332
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
120399 (AR)
Practice address
122 S 2ND St
Cabot, AR 72023-2943
Phone
(832) 775-2018
NPI assigned
Nov 15, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
120399ARMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 120399 AR Yes

Addresses

Primary practice location

122 S 2ND St
Cabot, AR 72023-2943

Mailing address

122 S 2ND St
Cabot, AR 72023-2943
Phone (501) 450-6350

Other providers in Cabot, AR

All providers in Cabot, AR · Psychiatric/Mental Health Nurse Practitioner in Arkansas

Sources for this page

Verify at the official NPI Registry.