Provider Demographics
NPI:1720825789
Name:QUESADA, KRISTIE AMANDA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:AMANDA
Last Name:QUESADA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 451052
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0025
Mailing Address - Country:US
Mailing Address - Phone:956-771-9177
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 451052
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-0025
Practice Address - Country:US
Practice Address - Phone:956-771-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily