National Provider Identifier Database

KACEE BODIFORD, APRN – NPI #1801350137
Family


Contact Information

KACEE BODIFORD, APRN
3150 E. HERITAGE PWY
PRAIRIE GROVE, AR72753-0000
Phone: 479-400-1140
Fax: 479-400-1151
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for KACEE BODIFORD

NPI Number 1801350137
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 01/31/2019
Last updated 12/09/2019 - About 6 years ago
Sole proprietor1 Yes
Identifiers
  • AR License #: A006070
  • AR Medicaid: 232286758
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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