Kristinia Pratt, MHPP, RN

Individual provider Active NPI Case Management Registered Nurse · Tuckerman, AR

NPI 1689928558 · NPPES record last updated Oct 31, 2012

Key facts

NPI
1689928558
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
R087658 (AR)
Practice address
102 Elm Street
Tuckerman, AR 72473
Phone
(870) 349-1313
Fax
(870) 349-1311
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R087658ARMDCase Management Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X R087658 AR Yes

Addresses

Primary practice location

102 Elm Street
Tuckerman, AR 72473

Mailing address

102 Elm Street
Tuckerman, AR 72473
Phone (870) 349-1313

Other providers in Tuckerman, AR

All providers in Tuckerman, AR · Case Management Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.