Provider Demographics
NPI:1063795565
Name:STATLER, KRISTINA LEE (CD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEE
Last Name:STATLER
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 HANA HWY
Mailing Address - Street 2:#206
Mailing Address - City:PAIA
Mailing Address - State:HI
Mailing Address - Zip Code:96779
Mailing Address - Country:US
Mailing Address - Phone:808-268-3527
Mailing Address - Fax:
Practice Address - Street 1:777 HANA HWY
Practice Address - Street 2:#206
Practice Address - City:PAIA
Practice Address - State:HI
Practice Address - Zip Code:96779-8124
Practice Address - Country:US
Practice Address - Phone:808-268-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula