Provider Demographics
NPI:1417608282
Name:PIKE, KRISTINE ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANN
Last Name:PIKE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W I 20 STE 120
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5871
Mailing Address - Country:US
Mailing Address - Phone:817-468-3393
Mailing Address - Fax:817-468-8734
Practice Address - Street 1:811 W I 20 STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5871
Practice Address - Country:US
Practice Address - Phone:817-468-3393
Practice Address - Fax:817-468-8734
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX841270163W00000X
TX1068308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse