Doctor Name: | KRISTINA DULANEY |
NPI Number: | 1487000808 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | A004727 |
Business Practice Address: | 611 Fletcher Pl Lonoke, AR - 720862326 |
Business Phone Number: | 5019125608 |
Business Fax Number: | |
Mailing Address: | Po Box 9178, RUSSELLVILLE |
State: | AR |
Postal Code: | 728119178 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/05/2016 |
NPI Last Update Date: | 05/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004727 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |