Provider Demographics
NPI:1073266052
Name:BYER, KRISTINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:BYER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:BRZOSTOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PROPHETSTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:61277-1334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PROPHETSTOWN
Practice Address - State:IL
Practice Address - Zip Code:61277-1334
Practice Address - Country:US
Practice Address - Phone:815-537-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165977363LF0000X
IL209.024551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily