Provider Demographics
NPI:1457036147
Name:LEVINS, KRISTINA RENEA (CRDH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:RENEA
Last Name:LEVINS
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 W FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1107
Mailing Address - Country:US
Mailing Address - Phone:850-418-3103
Mailing Address - Fax:
Practice Address - Street 1:1295 W FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1107
Practice Address - Country:US
Practice Address - Phone:850-418-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24515124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist