Provider Demographics
NPI:1760279806
Name:KOLANOVIC, KRISTINA (RN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:KOLANOVIC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 W 162ND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-5926
Mailing Address - Country:US
Mailing Address - Phone:646-859-9368
Mailing Address - Fax:
Practice Address - Street 1:523 W 162ND ST APT 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-5926
Practice Address - Country:US
Practice Address - Phone:646-859-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY771380163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health