Provider Demographics
NPI:1508841370
Name:ECKLAND, KRISTIN LYNN (ACNP, BC, RNFA)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:LYNN
Last Name:ECKLAND
Suffix:
Gender:F
Credentials:ACNP, BC, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 CRYSTAL SPRING AVE SW STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2465
Practice Address - Country:US
Practice Address - Phone:540-853-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV61944363LA2100X
VIPENDING363LA2100X
AZAP4242363LA2100X
VA0024167225363LA2100X
NC2005-01389363LA2100X
TNAPN0000011834363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN11834OtherADVANCED PRACTICE NURSE
2005009361-28OtherNATIONAL CERTIFICATION
VIPENDINGOtherNURSING LICENSE
WV61944OtherNURSING LICENSE/ ADVANCED
TN140397OtherRN LICENSE (NP PENDING)