Provider Demographics
NPI:1487299525
Name:ADAMS, KRISTY NICOLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:NICOLE
Last Name:ADAMS
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 1:2230 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7417
Mailing Address - Country:US
Mailing Address - Phone:870-698-2100
Mailing Address - Fax:870-698-0109
Practice Address - Street 1:2330 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7419
Practice Address - Country:US
Practice Address - Phone:870-698-2100
Practice Address - Fax:870-698-0109
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122193363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health