Provider Demographics
NPI:1962838979
Name:PLEASANT, KRISTIN JEAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JEAN
Last Name:PLEASANT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 S DICKINSON DR UNIT 140
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6434
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-815-2882
Practice Address - Street 1:1333 S DICKINSON DR UNIT 140
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6434
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:910-815-2882
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006471363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner