Provider Demographics
NPI:1922867845
Name:DENTLER, KRISTENE SUMMERS (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KRISTENE
Middle Name:SUMMERS
Last Name:DENTLER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 CASTLETON DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-7490
Mailing Address - Country:US
Mailing Address - Phone:804-384-7210
Mailing Address - Fax:
Practice Address - Street 1:448 CASTLETON DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-7490
Practice Address - Country:US
Practice Address - Phone:804-384-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN646692163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse