Provider Demographics
NPI:1164996211
Name:PRICE, KRISTIN (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1196
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:AR
Mailing Address - Zip Code:71744-1196
Mailing Address - Country:US
Mailing Address - Phone:870-798-4064
Mailing Address - Fax:870-798-4100
Practice Address - Street 1:1117 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:AR
Practice Address - Zip Code:71845-1013
Practice Address - Country:US
Practice Address - Phone:870-921-5781
Practice Address - Fax:870-798-4100
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily