Stacey Kirk
Individual provider Active NPI Case Manager/Care Coordinator · Centerton, AR
NPI 1467707166 · NPPES record last updated Jul 18, 2012
Key facts
- NPI
- 1467707166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 250 East Centerton Blvd.
Centerton, AR 72719 - Phone
- (479) 795-1802
- NPI assigned
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Bridge | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
250 East Centerton Blvd.
Centerton, AR 72719
Mailing address
2153 E. Joyce Blvd,
Fayetteville, AR 72703-5285
Other providers in Centerton, AR
- Alexis Johnson
- Jace Jordan Johnson
- M Lucille Kelley
- Kestrel Creek Counseling
- Rose N Kihm
- Kristi Lahusen
- Chulyndria Laye
- Kelsey Maloney-Steiner
- Matt McShane DDS PLLC
- Anna Janelle McCraw
All providers in Centerton, AR · Case Manager/Care Coordinator in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.