Provider Demographics
NPI:1982254017
Name:WESTER, KRISTINA
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:WESTER
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 1:10134 NW TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:ALTHA
Mailing Address - State:FL
Mailing Address - Zip Code:32421-2424
Mailing Address - Country:US
Mailing Address - Phone:850-693-0646
Mailing Address - Fax:
Practice Address - Street 1:10134 NW TUCKER RD
Practice Address - Street 2:
Practice Address - City:ALTHA
Practice Address - State:FL
Practice Address - Zip Code:32421-2424
Practice Address - Country:US
Practice Address - Phone:850-693-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider