Provider Demographics
NPI:1366148678
Name:CRAFTON, KIRSTIN (QBHP)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:CRAFTON
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:KIRSTIN
Other - Middle Name:NICOLE
Other - Last Name:SHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 S POPLAR ST STE F
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6000
Mailing Address - Country:US
Mailing Address - Phone:870-972-8779
Mailing Address - Fax:501-279-9450
Practice Address - Street 1:403 S POPLAR ST STE F
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6000
Practice Address - Country:US
Practice Address - Phone:870-972-8779
Practice Address - Fax:501-279-9450
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator