Provider Demographics
NPI:1710706247
Name:MUZNY, KRISTA MAE (RN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:MAE
Last Name:MUZNY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:MAE
Other - Last Name:LIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 36TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1542
Mailing Address - Country:US
Mailing Address - Phone:320-492-8962
Mailing Address - Fax:
Practice Address - Street 1:4801 VETERANS DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2015
Practice Address - Country:US
Practice Address - Phone:320-252-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1459207163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse