Provider Demographics
NPI:1427417633
Name:LEDBETTER, CRISTAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CRISTAN
Middle Name:
Last Name:LEDBETTER
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 1:5424 19TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2162
Mailing Address - Country:US
Mailing Address - Phone:806-722-4453
Mailing Address - Fax:
Practice Address - Street 1:5424 19TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2162
Practice Address - Country:US
Practice Address - Phone:806-722-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily