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NPI Code Detail

MEDICARE: KRISTIE NEWBORN

MEDICARE: KRISTIE NEWBORN
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
1390200000XStudent in an Organized Health Care Education/Training Program
2103K00000XBehavior Analyst1-22-61084AR

General Provider Information

NPI Number : 1427406156
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIE NEWBORN
Provider Business Mailing Address
First Line : 5532 JFK BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-6708
Country : US
Telephone Number : 501-588-3211
Fax Number : 501-353-2599
Provider Business Practice Location Address
First Line : 5532 JFK BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-6708
Country : US
Telephone Number : 501-588-3211
Fax Number : 501-353-2599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2016
Last Update Date : 02/09/2023

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Directions to “ KRISTIE NEWBORN ” Practice Location

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