Doctor Name: | KRISTIE D BRANSCUM |
NPI Number: | 1821437302 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | A003892 |
Business Practice Address: | 35 Grasse St Calico Rock, AR - 72519 |
Business Phone Number: | 8702972475 |
Business Fax Number: | 8702974380 |
Mailing Address: | Po Box 819, CALICO ROCK |
State: | AR |
Postal Code: | 725190819 |
Phone Number: | 8702972475 |
Fax Number: | 8702974380 |
NPI Enumeration Date: | 06/18/2013 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A003892 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |