Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | A005439 | AR |
Y | 363LA2100X | Nurse Practitioner - Acute Care | A005439 | AR |
N | 363LG0600X | Nurse Practitioner - Gerontology | A005439 | AR |
NPI | 1053819417 |
---|---|
Provider Name | Mrs. Kristen Paige Neldon |
First Address | Jonesboro, AR 72401-3119 |
Second Address | Jonesboro, AR 72401-4163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2018 |
Last Update Date | 17/03/2018 |