Provider Demographics
NPI:1063972248
Name:LOVING, KRISTA (RN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:LOVING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:MONTEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10955 CUB CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-1516
Mailing Address - Country:US
Mailing Address - Phone:813-352-7236
Mailing Address - Fax:
Practice Address - Street 1:9330 FL-54
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-834-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9471590163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency