Provider Demographics
NPI:1477156602
Name:WHITFIELD, KRISTIE W (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:W
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 N GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-1310
Mailing Address - Country:US
Mailing Address - Phone:919-288-9040
Mailing Address - Fax:
Practice Address - Street 1:1808 N GEORGE ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1310
Practice Address - Country:US
Practice Address - Phone:919-288-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20-0369R15246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy