Provider Demographics
NPI:1679997415
Name:LANTOS, KRISTINA LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:LYNN
Last Name:LANTOS
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 1:696 READ ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-1413
Mailing Address - Country:US
Mailing Address - Phone:401-263-3028
Mailing Address - Fax:
Practice Address - Street 1:696 READ ST
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-1413
Practice Address - Country:US
Practice Address - Phone:401-263-3028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse