Provider Demographics
NPI:1073388146
Name:REX, KRISTY SUE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:SUE
Last Name:REX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:SUE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:589 E BELL AVE
Mailing Address - Street 2:
Mailing Address - City:MCCONNELSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43756-1345
Mailing Address - Country:US
Mailing Address - Phone:304-966-6534
Mailing Address - Fax:
Practice Address - Street 1:589 E BELL AVE
Practice Address - Street 2:
Practice Address - City:MCCONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-1345
Practice Address - Country:US
Practice Address - Phone:304-966-6534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH519067163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence Care