Provider Demographics
NPI:1740989458
Name:MACASIAS, KRISTINE JOY BALLESTEROS (RN)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE JOY
Middle Name:BALLESTEROS
Last Name:MACASIAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 COOLIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-7824
Mailing Address - Country:US
Mailing Address - Phone:850-533-1122
Mailing Address - Fax:
Practice Address - Street 1:1700 WHEELING ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7211
Practice Address - Country:US
Practice Address - Phone:850-533-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9549834163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse