Provider Demographics
NPI:1124518154
Name:SWARTZENDRUBER, KRISTINA LEIGH
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LEIGH
Last Name:SWARTZENDRUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1910
Mailing Address - Country:US
Mailing Address - Phone:989-672-3870
Mailing Address - Fax:989-673-5953
Practice Address - Street 1:362 GREEN ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1910
Practice Address - Country:US
Practice Address - Phone:989-672-3870
Practice Address - Fax:989-673-5953
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator