Individual provider · Type 1 NPI

Kellie Jean Willis, LPN

Licensed Practical Nurse · Clarksville, AR

NPI number 1083536403 Active

Practice location

1701 W Clark Rd
Clarksville, AR 72830-3915

Specialties and licenses

Taxonomy	Code	License
Licensed Practical Nurse Primary	164W00000X	120805 (AR)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

3 other providers at this address

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About NPI 1083536403

Kellie Jean Willis, LPN's National Provider Identifier is 1083536403, issued on Jul 28, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Clarksville, AR. The record was last updated on Jul 28, 2026.