Provider Demographics
NPI:1588293237
Name:CARAZO, KRISTIE NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:NICOLE
Last Name:CARAZO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3825
Mailing Address - Country:US
Mailing Address - Phone:225-655-6422
Mailing Address - Fax:225-341-5903
Practice Address - Street 1:62 MAIN ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1146
Practice Address - Country:US
Practice Address - Phone:207-858-4844
Practice Address - Fax:207-858-0348
Is Sole Proprietor?:No
Enumeration Date:2020-04-05
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA212197363LF0000X
MECNP231523363LF0000X
CA95027152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily