Provider Demographics
NPI:1134436462
Name:ROSENCRANS, CRISTY CAY (RN,CCM,PLNC)
Entity type:Individual
Prefix:
First Name:CRISTY
Middle Name:CAY
Last Name:ROSENCRANS
Suffix:
Gender:F
Credentials:RN,CCM,PLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 BELSHE ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-7879
Mailing Address - Country:US
Mailing Address - Phone:573-596-1677
Mailing Address - Fax:573-596-5362
Practice Address - Street 1:126 MISSOURI AVE # 1268
Practice Address - Street 2:
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:MO
Practice Address - Zip Code:65473-8952
Practice Address - Country:US
Practice Address - Phone:573-596-5337
Practice Address - Fax:573-596-5362
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003015958163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management