Provider Demographics
NPI:1184341141
Name:CHRISTOPHER, KRYSTAL MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:MICHELLE
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 SW 72ND AVE APT 1906
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-8019
Mailing Address - Country:US
Mailing Address - Phone:305-915-9651
Mailing Address - Fax:
Practice Address - Street 1:8600 SW 92ND ST STE 204B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7377
Practice Address - Country:US
Practice Address - Phone:305-436-9933
Practice Address - Fax:305-436-2985
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022382363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care