Provider Demographics
NPI:1245469170
Name:HEINRICH, KRISTY LEE (RN)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LEE
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LARRIMORE RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-3413
Mailing Address - Country:US
Mailing Address - Phone:914-476-3643
Mailing Address - Fax:914-476-3643
Practice Address - Street 1:4 LARRIMORE RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-3413
Practice Address - Country:US
Practice Address - Phone:914-476-3643
Practice Address - Fax:914-476-3643
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY530076-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse