Provider Demographics
NPI:1417389701
Name:FRANCIS, KRISTA LYNN
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:LYNN
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-3401
Mailing Address - Country:US
Mailing Address - Phone:315-764-0221
Mailing Address - Fax:315-705-6434
Practice Address - Street 1:267 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3401
Practice Address - Country:US
Practice Address - Phone:315-764-0221
Practice Address - Fax:315-705-6434
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily