Provider Demographics
NPI:1023860657
Name:CARR, KRISTA K (RN CHPN)
Entity type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:K
Last Name:CARR
Suffix:
Gender:F
Credentials:RN CHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 APRIL MEADOWS LOOP
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7098
Mailing Address - Country:US
Mailing Address - Phone:806-336-4809
Mailing Address - Fax:
Practice Address - Street 1:8133 MESA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8655
Practice Address - Country:US
Practice Address - Phone:512-815-9009
Practice Address - Fax:512-233-5161
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643076163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice