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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 Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KACEE BODIFORD · (Female)

NPI Number 1801350137
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 01/31/2019
Last updated 12/09/2019 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # A006070
  • AR Medicaid 232286758
Hospital affiliation(s) Not Available
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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