Provider Demographics
NPI: | 1427475011 |
---|---|
Name: | HUENINK, KRISTIN RENEE (NP-C) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | KRISTIN |
Middle Name: | RENEE |
Last Name: | HUENINK |
Suffix: | |
Gender: | F |
Credentials: | NP-C |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 10440 LITTLE PATUXENT PKWY STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21044-3648 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-731-8994 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 222 2ND AVE S FL 17 |
Practice Address - Street 2: | |
Practice Address - City: | NASHVILLE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37201-2366 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-731-8994 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2014-03-21 |
Last Update Date: | 2025-04-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | RN1053196 | 363LA2200X |
TN | 35960 | 363LA2200X |
CO | C-ANP.0000173-C-NP | 363LA2200X |
MO | 2021005464 | 363LA2200X |
FL | TPAN2187 | 363LA2200X |
GA | GAA-NP002152 | 363LA2200X |
VA | 0024174038 | 363LA2200X |
MD | AC002700 | 363LA2200X |
TX | 1116997 | 363LA2200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |