Provider Demographics
NPI:1639360340
Name:KOHLER, KRISTINA MARIA (CNM)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MARIA
Last Name:KOHLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:KOHLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:116 NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-2960
Mailing Address - Country:US
Mailing Address - Phone:201-984-1270
Mailing Address - Fax:551-554-3617
Practice Address - Street 1:116 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2960
Practice Address - Country:US
Practice Address - Phone:201-984-1270
Practice Address - Fax:551-554-3617
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1564261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty