Provider Demographics
NPI:1679600241
Name:CAPOZZI, KRISTINA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:CAPOZZI
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 1:13956 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14034
Mailing Address - Country:US
Mailing Address - Phone:716-532-5379
Mailing Address - Fax:
Practice Address - Street 1:10714 NORTH RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:NY
Practice Address - Zip Code:14129-9746
Practice Address - Country:US
Practice Address - Phone:716-532-2018
Practice Address - Fax:716-532-0116
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5490371163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse