Provider Demographics
NPI:1457890477
Name:MERGES, KRISTINA MARY (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:MARY
Last Name:MERGES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PARKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2807
Mailing Address - Country:US
Mailing Address - Phone:518-459-3938
Mailing Address - Fax:
Practice Address - Street 1:14 PARKWOOD ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2807
Practice Address - Country:US
Practice Address - Phone:518-459-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293549-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse