Provider Demographics
NPI:1316264351
Name:HANSEN, KRISTY B
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:B
Last Name:HANSEN
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 1:5824 BAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2881
Mailing Address - Country:US
Mailing Address - Phone:919-757-9143
Mailing Address - Fax:
Practice Address - Street 1:5824 BAYBERRY LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2881
Practice Address - Country:US
Practice Address - Phone:919-757-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula