Provider Demographics
NPI:1477534600
Name:VERDI, KRISTA MICHELE (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:MICHELE
Last Name:VERDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:M
Other - Last Name:BEHNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5445 LANARK RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8694
Mailing Address - Country:US
Mailing Address - Phone:484-526-5210
Mailing Address - Fax:866-568-6561
Practice Address - Street 1:5445 LANARK RD STE 202
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8694
Practice Address - Country:US
Practice Address - Phone:484-526-5210
Practice Address - Fax:866-568-6561
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102906363AM0700X
PAMA055207363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291922200Medicaid
GA533760182AMedicaid
FLU3517WMedicare PIN
FLQ2455Medicare UPIN
GA533760182AMedicaid