Provider Demographics
NPI:1215359138
Name:WOLSKI, KRISTINA M SMITH (RN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M SMITH
Last Name:WOLSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2957 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14423-1215
Mailing Address - Country:US
Mailing Address - Phone:585-298-8274
Mailing Address - Fax:
Practice Address - Street 1:2957 MAIN ST
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:NY
Practice Address - Zip Code:14423-1215
Practice Address - Country:US
Practice Address - Phone:585-298-8274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342045-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse