Provider Demographics
NPI:1871976852
Name:WOOLSEY, KRISTYL (APRN)
Entity type:Individual
Prefix:
First Name:KRISTYL
Middle Name:
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-625-8400
Mailing Address - Fax:501-625-8446
Practice Address - Street 1:1662 HIGDON FERRY RD
Practice Address - Street 2:SUITE 230
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6999
Practice Address - Country:US
Practice Address - Phone:501-623-9581
Practice Address - Fax:501-520-4212
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARATP 000827363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR211241758Medicaid