Provider Demographics
NPI:1700494390
Name:YOKUM, KRISTINA
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:YOKUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-0665
Mailing Address - Country:US
Mailing Address - Phone:304-636-9396
Mailing Address - Fax:
Practice Address - Street 1:42 WILDWIND LN
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:WV
Practice Address - Zip Code:26283-7076
Practice Address - Country:US
Practice Address - Phone:304-636-9396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator