Provider Demographics
NPI:1164862637
Name:JONES, KRISTINA M (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:M
Other - Last Name:LETCHWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AANP
Mailing Address - Street 1:30029 SCR 4300
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462
Mailing Address - Country:US
Mailing Address - Phone:582-266-8244
Mailing Address - Fax:
Practice Address - Street 1:34 LAVELLE CT #A
Practice Address - Street 2:
Practice Address - City:UNALASKA
Practice Address - State:AK
Practice Address - Zip Code:99685
Practice Address - Country:US
Practice Address - Phone:907-581-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80697363LF0000X
AR103236363LF0000X
OR20901739NP-PP363LF0000X
AK177470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK368195YLX3OtherMEDICARE
AR561266ZGV1OtherMEDICARE
OK200501810AMedicaid
AR218607758Medicaid