Provider Demographics
NPI:1447379524
Name:KINDT, CHRISTENNA LOUISE (FNP, RN, MSN)
Entity Type:Individual
Prefix:
First Name:CHRISTENNA
Middle Name:LOUISE
Last Name:KINDT
Suffix:
Gender:F
Credentials:FNP, RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GATEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-3008
Mailing Address - Country:US
Mailing Address - Phone:843-767-2695
Mailing Address - Fax:
Practice Address - Street 1:9330 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9104
Practice Address - Country:US
Practice Address - Phone:843-847-4372
Practice Address - Fax:843-847-5187
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1675363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily