Healthcare Provider Details

I. General information

NPI: 1770408528
Provider Name (Legal Business Name): CHRISTA CAROLINE TINER RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E WASHINGTON ST
HAZEN AR
72064-8163
US

IV. Provider business mailing address

1005 E WASHINGTON ST
HAZEN AR
72064-8163
US

V. Phone/Fax

Practice location:
  • Phone: 870-673-7211
  • Fax: 870-255-3989
Mailing address:
  • Phone: 870-673-7211
  • Fax: 870-255-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR101844
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: