Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bj Kidwell

Individual provider Family Nurse Practitioner · NPI 1366102253

Bj Kidwell is a Nurse Practitioner in Bentonville, Arkansas. Qualified in 2021, 5 years ago. Practices with LSU Health Sciences Center Shreveport Faculty Group Practice, a 569-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arkansas and Louisiana.

Years since qualifying
5
Licensed in
AR, LA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

3101 SE 14th St
Bentonville, AR 72712-4900
Phone: (479) 250-1053
Fax: (479) 250-0923
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4864 Jackson St, Monroe, LA 71202-6400 — (318) 330-7000

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 218019 (AR)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 223761 (LA)

Record details

NPI number1366102253
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 20, 2021
Last updated in NPPESJune 20, 2023
Certification dateJune 20, 2023
Mailing address3101 Se 14th St, Bentonville, AR 72712-4900

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Lsu Health Sciences Center Shreveport Faculty Group Practice — 569 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bentonville