Provider Demographics
NPI:1942017587
Name:TAYLOR, KRISTINA (AANWP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AANWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 N BELCHER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1328
Mailing Address - Country:US
Mailing Address - Phone:727-330-7191
Mailing Address - Fax:
Practice Address - Street 1:1744 N BELCHER RD STE 100
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1328
Practice Address - Country:US
Practice Address - Phone:727-330-7191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education