Provider Demographics
NPI:1174949812
Name:DELOACHE, KRISTINA BROWN (RN, NNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:BROWN
Last Name:DELOACHE
Suffix:
Gender:F
Credentials:RN, NNP-BC
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:NICOLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:ROOM 4051, NC MEMORIAL HOSPITAL
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7596
Mailing Address - Country:US
Mailing Address - Phone:919-966-5063
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:ROOM 4051, NC MEMORIAL HOSPITAL
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7596
Practice Address - Country:US
Practice Address - Phone:919-966-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCDELO-11P1TM363LN0000X
NC5006795363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal