Provider Demographics
NPI:1073222691
Name:WHITCOMB, KRISTINE A (CHW, CPRS)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:A
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:CHW, CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 CHANDLER AVE N
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-2823
Mailing Address - Country:US
Mailing Address - Phone:320-510-1993
Mailing Address - Fax:
Practice Address - Street 1:742 CLEVELAND AVENUE SE
Practice Address - Street 2:APT 104
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5535
Practice Address - Country:US
Practice Address - Phone:320-298-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker