Provider Demographics
NPI:1245872589
Name:JUNKIN, KRISTYN NICOLE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:NICOLE
Last Name:JUNKIN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 FAIRFAX PARK STE C
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2837
Mailing Address - Country:US
Mailing Address - Phone:205-752-7337
Mailing Address - Fax:205-752-8013
Practice Address - Street 1:1060 FAIRFAX PARK STE C
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2837
Practice Address - Country:US
Practice Address - Phone:205-752-7337
Practice Address - Fax:205-752-8013
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141600163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant