Provider Demographics
NPI:1669097317
Name:WILLENBRING, KRISTA ANN (AUD)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:ANN
Last Name:WILLENBRING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:ANN
Other - Last Name:OSTWINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2710 SAINT FRANCIS DR STE 411
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5634
Mailing Address - Country:US
Mailing Address - Phone:319-272-5000
Mailing Address - Fax:319-272-5825
Practice Address - Street 1:2710 SAINT FRANCIS DR STE 411
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5634
Practice Address - Country:US
Practice Address - Phone:319-272-5000
Practice Address - Fax:319-272-5825
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101275231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist