Provider Demographics
NPI:1447297320
Name:CRONKHITE, KRISTIE N (ANP)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:N
Last Name:CRONKHITE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6202
Mailing Address - Country:US
Mailing Address - Phone:501-255-6000
Mailing Address - Fax:501-255-6400
Practice Address - Street 1:10100 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6202
Practice Address - Country:US
Practice Address - Phone:501-255-6000
Practice Address - Fax:501-255-6400
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01632 ANP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X285Medicare PIN
ARP63802Medicare UPIN