Provider Demographics
NPI:1467215749
Name:CROOKS, KRISTEN JOHANNA (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JOHANNA
Last Name:CROOKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 HERON AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-3120
Mailing Address - Country:US
Mailing Address - Phone:786-201-1819
Mailing Address - Fax:
Practice Address - Street 1:311 9TH ST N STE 304
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5887
Practice Address - Country:US
Practice Address - Phone:239-624-8250
Practice Address - Fax:239-624-8171
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9571178163WC0200X
FL11027853363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine