Provider Demographics
NPI:1003484395
Name:WEST, KRISTINA MARIA (RN)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:MARIA
Last Name:WEST
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 1:1625 ALOHA AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3431
Mailing Address - Country:US
Mailing Address - Phone:254-371-2230
Mailing Address - Fax:
Practice Address - Street 1:344 HEARD AVENUE
Practice Address - Street 2:BLDG 556 RM 137
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-655-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628439163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management