Individual
KRISTIE D BRANSCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
35 GRASSE ST, CALICO ROCK, AR 72519
(870) 297-2475
(870) 297-4380
Mailing address
PO BOX 819, CALICO ROCK, AR 72519-0819
(870) 297-2475
(870) 297-4380
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003892
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199752758
—
AR
01
—
5UU88
BCBS
AR
01
—
PO1210713
RAILROAD MEDICARE
—
Enumeration date
06/18/2013
Last updated
02/14/2017
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