Provider Demographics
NPI:1336797166
Name:WHITE, KRISINDA MICHELLE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISINDA
Middle Name:MICHELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:KRISINDA
Other - Middle Name:MICHELLE
Other - Last Name:CAYWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 COBALT AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-6373
Mailing Address - Country:US
Mailing Address - Phone:281-744-4121
Mailing Address - Fax:
Practice Address - Street 1:214 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3748
Practice Address - Country:US
Practice Address - Phone:307-634-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY44405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care