Healthcare Provider Details

I. General information

NPI: 1326425919
Provider Name (Legal Business Name): KRISTYN LAMBERT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2015
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 SCHNEIDER DR STE 104
MALVERN AR
72104-4823
US

IV. Provider business mailing address

6801 MILITARY RD
MALVERN AR
72104-7343
US

V. Phone/Fax

Practice location:
  • Phone: 501-337-9994
  • Fax:
Mailing address:
  • Phone: 870-816-8274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR88701
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number123577
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: