Provider Demographics
NPI:1164910717
Name:FALCONE, KRISTA MICHELLE (BS, FCP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:MICHELLE
Last Name:FALCONE
Suffix:
Gender:F
Credentials:BS, FCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5226
Mailing Address - Country:US
Mailing Address - Phone:765-462-9988
Mailing Address - Fax:
Practice Address - Street 1:801 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4075
Practice Address - Country:US
Practice Address - Phone:765-462-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator