Healthcare Provider Details

I. General information

NPI: 1285389262
Provider Name (Legal Business Name): KRISTINA M DEAN APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 MARKET TRCE
FORT SMITH AR
72908-8694
US

IV. Provider business mailing address

2707 MARKET TRCE
FORT SMITH AR
72908-8694
US

V. Phone/Fax

Practice location:
  • Phone: 479-434-3600
  • Fax: 833-992-0797
Mailing address:
  • Phone: 479-434-3600
  • Fax: 833-992-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0131477
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number206812
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number219144
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: