Provider Demographics
NPI:1003383191
Name:ANDREWS, KRISTEN BETH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:BETH
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:BETH
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:65 SOUTH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2418
Mailing Address - Country:US
Mailing Address - Phone:518-775-3289
Mailing Address - Fax:
Practice Address - Street 1:65 SOUTH ST APT 2
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2418
Practice Address - Country:US
Practice Address - Phone:518-775-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239976-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse