Provider Demographics
NPI:1205390630
Name:SWEARINGEN, KRISTA RONNITA (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:RONNITA
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 361095
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32936-1095
Mailing Address - Country:US
Mailing Address - Phone:321-241-6400
Mailing Address - Fax:321-428-3945
Practice Address - Street 1:8095 SPYGLASS HILL RD STE 104
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8290
Practice Address - Country:US
Practice Address - Phone:321-241-6400
Practice Address - Fax:321-428-3945
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily