Provider Demographics
NPI:1770164899
Name:ADAIR, KRISTIAN (APRN, FNP)
Entity type:Individual
Prefix:
First Name:KRISTIAN
Middle Name:
Last Name:ADAIR
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 N FRANKLIN ST UNIT 1115
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3818
Mailing Address - Country:US
Mailing Address - Phone:239-405-5605
Mailing Address - Fax:
Practice Address - Street 1:5033 W LAUREL ST STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3855
Practice Address - Country:US
Practice Address - Phone:813-922-8939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012757363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily