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

Kasilynn Alese Shaddy

Individual provider Nurse Practitioner · NPI 1144836909

Kasilynn Alese Shaddy is a Nurse Practitioner in Springdale, Arkansas. Qualified in 2020, 6 years ago. Practices with Premier Family Health Care LLC, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arkansas.

Years since qualifying
6
Licensed in
AR
In the registry since
2020
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Practice location Address checks out

3300 W Sunset Ave
Springdale, AR 72762-4950
Phone: (479) 717-7089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 125710 (AR)

Record details

NPI number1144836909
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 17, 2020
Last updated in NPPESSeptember 17, 2020
Certification dateSeptember 17, 2020
Mailing address3300 W Sunset Ave, Springdale, AR 72762-4950

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Premier Family Health Care Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Springdale