Provider Demographics
NPI:1245977818
Name:LEDBETTER, KRISTINA NOEL (DO)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:NOEL
Last Name:LEDBETTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6039
Mailing Address - Country:US
Mailing Address - Phone:850-969-4507
Mailing Address - Fax:
Practice Address - Street 1:5000 LAKEWOOD RANCH BLVD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4909
Practice Address - Country:US
Practice Address - Phone:941-782-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program