Provider Demographics
NPI:1487412938
Name:BRITTON, KRISTINA MARIE (LM, CPM)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:BRITTON
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:M
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:8735 WESTSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-8335
Mailing Address - Country:US
Mailing Address - Phone:517-214-2620
Mailing Address - Fax:
Practice Address - Street 1:8735 WESTSIDE RD
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-8335
Practice Address - Country:US
Practice Address - Phone:517-214-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife