Provider Demographics
NPI:1114157542
Name:WEBB, KRISTINA MADISON (DI)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:MADISON
Last Name:WEBB
Suffix:
Gender:F
Credentials:DI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 MAJESTIC DR
Mailing Address - Street 2:PO BOX 910142
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-9998
Mailing Address - Country:US
Mailing Address - Phone:859-797-8641
Mailing Address - Fax:
Practice Address - Street 1:124 VENTURE CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2629
Practice Address - Country:US
Practice Address - Phone:859-797-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker