Provider Demographics
NPI:1588829881
Name:CREWS, KRISTINA (CNA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:CREWS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 GARDNER DR.
Mailing Address - Street 2:
Mailing Address - City:LORIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33857
Mailing Address - Country:US
Mailing Address - Phone:863-655-5423
Mailing Address - Fax:863-655-3306
Practice Address - Street 1:2009 GARDNER DR
Practice Address - Street 2:
Practice Address - City:LORIDA
Practice Address - State:FL
Practice Address - Zip Code:33857-9442
Practice Address - Country:US
Practice Address - Phone:863-655-5423
Practice Address - Fax:863-655-3306
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL157546376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide