Provider Demographics
NPI:1992181549
Name:LONDO, KRISTINA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LONDO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2055
Mailing Address - Country:US
Mailing Address - Phone:608-751-9379
Mailing Address - Fax:
Practice Address - Street 1:236 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-2055
Practice Address - Country:US
Practice Address - Phone:608-751-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI199740163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse