Provider Demographics
NPI:1902072671
Name:RADFORD, NAKITA TERELL (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:NAKITA
Middle Name:TERELL
Last Name:RADFORD
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CLEARVIEW
Mailing Address - Street 2:
Mailing Address - City:WEST HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72390-1728
Mailing Address - Country:US
Mailing Address - Phone:870-816-0213
Mailing Address - Fax:870-338-8048
Practice Address - Street 1:406 PECAN ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-3212
Practice Address - Country:US
Practice Address - Phone:870-338-8447
Practice Address - Fax:870-338-8048
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator