Provider Demographics
NPI:1780203075
Name:PRITCHARD, KRISTA BROOKE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:BROOKE
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E CROSS ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-3501
Mailing Address - Country:US
Mailing Address - Phone:319-666-4224
Mailing Address - Fax:
Practice Address - Street 1:1208 E CROSS ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-3501
Practice Address - Country:US
Practice Address - Phone:319-666-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA168316363LF0000X
OK98684363LF0000X, 163W00000X
OKR0098684363LF0000X
MS906230363LF0000X
TX1154899363LF0000X
TN35525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse