Provider Demographics
NPI:1710645056
Name:SAWYER, KRISTIN N (RN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:N
Last Name:SAWYER
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 1:12550 HESPERIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5873
Mailing Address - Country:US
Mailing Address - Phone:760-241-6666
Mailing Address - Fax:
Practice Address - Street 1:12550 HESPERIA RD STE 100
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5873
Practice Address - Country:US
Practice Address - Phone:760-956-4154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286171163W00000X
CA826171163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse