Provider Demographics
NPI:1720051139
Name:MASTERSON, KRISTI ANN (RNC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 GAFFNEY ROAD
Mailing Address - Street 2:COMMANDER, USA-MEDDAC,AK, ATTN; MCUC-MMD-QM
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-4845
Mailing Address - Country:US
Mailing Address - Phone:907-353-5418
Mailing Address - Fax:
Practice Address - Street 1:1060 GAFFNEY ROAD
Practice Address - Street 2:BASSETT ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-4845
Practice Address - Country:US
Practice Address - Phone:907-353-5158
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-71060-101163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn