Provider Demographics
NPI:1922764869
Name:DICKENSHEETS, KRISTI LYNN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:DICKENSHEETS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W CENTRAL AVE
Mailing Address - Street 2:PMB 156
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066
Mailing Address - Country:US
Mailing Address - Phone:937-567-2131
Mailing Address - Fax:937-889-2873
Practice Address - Street 1:752 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-8944
Practice Address - Country:US
Practice Address - Phone:937-208-6865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.390886163WE0003X
OHAPRN.CNP.0030447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency