Provider Demographics
NPI:1912609934
Name:AGGUGELO, KRISTINA
Entity type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:
Last Name:AGGUGELO
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 1:23 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1953
Mailing Address - Country:US
Mailing Address - Phone:314-605-7059
Mailing Address - Fax:
Practice Address - Street 1:23 HARRIS DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1953
Practice Address - Country:US
Practice Address - Phone:314-605-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care