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General NPI Number Information
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NPI Number | 1801324751
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Entity Type | Individual
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Provider Name | KRISTIN JANELL BEEN ATC
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Gender | Female
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 3205 JENNY LIND RD
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City | FORT SMITH
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State | AR
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Zip | 72901-7101
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Country | US
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Telephone | 479-785-2501
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Fax | 479-420-3655
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Provider Business Mailing Address
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Address Line | 2905 LOVE ST
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City | POCOLA
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State | OK
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Zip | 74902-2454
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Country | US
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Telephone | 918-721-1753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 484
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License Number State | AR
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