Basic Information
| Provider Information | |||||||||
| NPI: | 1336569854 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNN | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3898 HIGHWAY 1 NORTH | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723353409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706332120 | ||||||||
| FaxNumber: | 8706331738 | ||||||||
| Practice Location | |||||||||
| Address1: | 3898 HIGHWAY 1 NORTH | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723353409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706332120 | ||||||||
| FaxNumber: | 8706331738 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2014 | ||||||||
| LastUpdateDate: | 10/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 163W00000X | R84796 | AR | Y | Nursing Service Providers | Registered Nurse |
No ID Information.