Provider Demographics
NPI:1073209490
Name:FELTON, KRISTA (LPN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 REGENCY AVE
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7009
Mailing Address - Country:US
Mailing Address - Phone:740-877-7701
Mailing Address - Fax:
Practice Address - Street 1:324 REGENCY AVE
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7009
Practice Address - Country:US
Practice Address - Phone:740-877-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140203164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse