Provider Demographics
NPI:1285389262
Name:DEAN, KRISTINA M (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:DEAN
Suffix:
Gender:
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 MARKET TRCE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8694
Mailing Address - Country:US
Mailing Address - Phone:479-434-3600
Mailing Address - Fax:833-992-0797
Practice Address - Street 1:2707 MARKET TRCE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8694
Practice Address - Country:US
Practice Address - Phone:479-434-3600
Practice Address - Fax:833-992-0797
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0131477163W00000X
OK206812363LF0000X
AR219144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse