Provider Demographics
NPI:1134100977
Name:KILLINS, KRISTA A (RN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTA
Middle Name:A
Last Name:KILLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1504
Mailing Address - Country:US
Mailing Address - Phone:732-544-0968
Mailing Address - Fax:
Practice Address - Street 1:PATTERSON ARMY HEALTH CLINIC
Practice Address - Street 2:BLDG 1075 STEPHENSON AVE-FT MONMOUTH
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07703
Practice Address - Country:US
Practice Address - Phone:732-532-1244
Practice Address - Fax:732-532-6586
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10750400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse