Provider Demographics
NPI:1750785978
Name:ROBERTS, KRISTINA DANIELLE (ND)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:DANIELLE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-1268 LIHAU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-9107
Mailing Address - Country:US
Mailing Address - Phone:207-432-0341
Mailing Address - Fax:
Practice Address - Street 1:75-169 HUALALAI RD
Practice Address - Street 2:SUITE 301
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1744
Practice Address - Country:US
Practice Address - Phone:808-329-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI263208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice