Provider Demographics
NPI:1518268853
Name:DEAL, KRISTY SUZANNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTY
Middle Name:SUZANNE
Last Name:DEAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CRAMERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28032-1407
Mailing Address - Country:US
Mailing Address - Phone:704-648-9264
Mailing Address - Fax:
Practice Address - Street 1:188 CENTER ST
Practice Address - Street 2:
Practice Address - City:CRAMERTON
Practice Address - State:NC
Practice Address - Zip Code:28032-1407
Practice Address - Country:US
Practice Address - Phone:704-648-9264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC216338171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor