Healthcare Provider Details

I. General information

NPI: 1902554314
Provider Name (Legal Business Name): CHRISTI DEANN PROFFITT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 W WASHINGTON ST
CAMDEN AR
71701-3828
US

IV. Provider business mailing address

1023 W WASHINGTON ST
CAMDEN AR
71701-3828
US

V. Phone/Fax

Practice location:
  • Phone: 870-231-7161
  • Fax: 870-231-7188
Mailing address:
  • Phone: 870-231-7161
  • Fax: 870-231-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number218986
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number218986
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: