Healthcare Provider Details

I. General information

NPI: 1760991640
Provider Name (Legal Business Name): KRISTEN LEIGH HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2017
Last Update Date: 11/26/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 EAST CENTRAL
WARREN AR
71671
US

IV. Provider business mailing address

304 EAST CENTRAL
WARREN AR
71671
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-8636
  • Fax: 870-226-8655
Mailing address:
  • Phone: 870-723-3691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR084156
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA005618
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: