Provider Demographics
NPI:1902554314
Name:PROFFITT, CHRISTI DEANN (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:DEANN
Last Name:PROFFITT
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 1:402SOUTH LEE STREET
Mailing Address - Street 2:
Mailing Address - City:HAMPTOM
Mailing Address - State:AR
Mailing Address - Zip Code:71744
Mailing Address - Country:US
Mailing Address - Phone:870-798-4299
Mailing Address - Fax:
Practice Address - Street 1:402SOUTH LEE STREET
Practice Address - Street 2:
Practice Address - City:HAMPTOM
Practice Address - State:AR
Practice Address - Zip Code:71744
Practice Address - Country:US
Practice Address - Phone:870-798-4299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR218986208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice