Provider Demographics
NPI:1316901804
Name:HOLLSTEIN, KRISTINA ANN (DC, DABCO)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANN
Last Name:HOLLSTEIN
Suffix:
Gender:F
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 TWIN C LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2157
Mailing Address - Country:US
Mailing Address - Phone:302-892-9355
Mailing Address - Fax:302-892-3494
Practice Address - Street 1:1101 TWIN C LN
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2157
Practice Address - Country:US
Practice Address - Phone:302-892-9355
Practice Address - Fax:302-892-3494
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000198111NX0800X
PADC003015L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU01970Medicare UPIN
DE000L80D73Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER