Provider Demographics
NPI:1437028495
Name:WINDNAGLE, KRYSTA
Entity type:Individual
Prefix:
First Name:KRYSTA
Middle Name:
Last Name:WINDNAGLE
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 1:193 WINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-1500
Mailing Address - Country:US
Mailing Address - Phone:607-962-6706
Mailing Address - Fax:
Practice Address - Street 1:193 WINFIELD ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-1500
Practice Address - Country:US
Practice Address - Phone:607-962-6706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY976866163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse