Provider Demographics
NPI:1316004153
Name:TOOKER, KRISTIN DEANNE (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DEANNE
Last Name:TOOKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2003
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4503
Mailing Address - Country:US
Mailing Address - Phone:315-446-3904
Mailing Address - Fax:315-445-2936
Practice Address - Street 1:221 BROAD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2178
Practice Address - Country:US
Practice Address - Phone:315-363-5421
Practice Address - Fax:315-363-5472
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily