Provider Demographics
NPI:1407594955
Name:SANCHEZ, KRISTA RENEE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:RENEE
Last Name:SANCHEZ
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 1:1048 N 120TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3306
Mailing Address - Country:US
Mailing Address - Phone:414-469-7549
Mailing Address - Fax:
Practice Address - Street 1:1048 N 120TH ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3306
Practice Address - Country:US
Practice Address - Phone:414-469-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI256682163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health