Provider Demographics
NPI:1255967790
Name:WHITE, KRISTIN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:BJORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:305 W RUSK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-2337
Mailing Address - Country:US
Mailing Address - Phone:903-500-8252
Mailing Address - Fax:
Practice Address - Street 1:305 W RUSK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2337
Practice Address - Country:US
Practice Address - Phone:903-500-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1082982363LF0000X
TX924938163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse