Provider Demographics
NPI:1386726180
Name:LOUIS, KRISTAN B (RNAPNC)
Entity type:Individual
Prefix:MS
First Name:KRISTAN
Middle Name:B
Last Name:LOUIS
Suffix:
Gender:F
Credentials:RNAPNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 QUILL CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3854
Mailing Address - Country:US
Mailing Address - Phone:201-831-0267
Mailing Address - Fax:
Practice Address - Street 1:610 VALLEY HEALTH PLAZA
Practice Address - Street 2:CARE PLUS NJ,INC
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:210-262-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC03834900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health