Provider Demographics
NPI:1053719849
Name:WEBER, KRISTA ANNE (CRNA)
Entity type:Individual
Prefix:MISS
First Name:KRISTA
Middle Name:ANNE
Last Name:WEBER
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78-6831 ALII DR STE E239
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2495
Mailing Address - Country:US
Mailing Address - Phone:808-909-3139
Mailing Address - Fax:
Practice Address - Street 1:75-5905 WALUA RD STE 4
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-5315
Practice Address - Country:US
Practice Address - Phone:808-331-7960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012275367500000X
HIAPRN-4034367500000X
IL041.361640163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse