Provider Demographics
NPI:1952846008
Name:SPIVEY, KRISTINA WING (NP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:WING
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N JUSTICE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3410
Mailing Address - Country:US
Mailing Address - Phone:828-696-4270
Mailing Address - Fax:828-696-4734
Practice Address - Street 1:260 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3378
Practice Address - Country:US
Practice Address - Phone:828-883-5330
Practice Address - Fax:828-883-5242
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009178363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCW348BMedicare PIN
NCNCW348A194Medicare PIN
NCNCW348AMedicare PIN