Provider Demographics
NPI:1760115067
Name:D'ELIA, KRISTYN (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:D'ELIA
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4982 EGRET CT
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2416
Mailing Address - Country:US
Mailing Address - Phone:954-790-0960
Mailing Address - Fax:
Practice Address - Street 1:5697 CORAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3160
Practice Address - Country:US
Practice Address - Phone:954-580-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL658779363LF0000X
FL11020636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily