Provider Demographics
NPI:1780245365
Name:ESKRIDGE, KRISTIE LASHAE (RN)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LASHAE
Last Name:ESKRIDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:LASHAE
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9518 49TH AVE W APT 15F
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3763
Mailing Address - Country:US
Mailing Address - Phone:601-212-7826
Mailing Address - Fax:
Practice Address - Street 1:10710 MUKILTEO SPEEDWAY
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5021
Practice Address - Country:US
Practice Address - Phone:425-349-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN6056494163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse