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NPI Code Detail

MEDICARE: KRISTINA M DEAN APRN, FNP-BC

MEDICARE: KRISTINA M DEAN APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR0131477OK
2363LF0000XFamily Nurse Practitioner206812OK
3363LF0000XFamily Nurse Practitioner219144AR

General Provider Information

NPI Number : 1285389262
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA M DEAN APRN, FNP-BC
Provider Business Mailing Address
First Line : 2707 MARKET TRCE
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-8694
Country : US
Telephone Number : 479-434-3600
Fax Number : 833-992-0797
Provider Business Practice Location Address
First Line : 2707 MARKET TRCE
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-8694
Country : US
Telephone Number : 479-434-3600
Fax Number : 833-992-0797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2022
Last Update Date : 03/20/2025

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