Provider Demographics
NPI:1780995282
Name:FINK, KRISTIN (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:FINK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:SKREDENSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8011 CLAYTON RD STE 209
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1156
Mailing Address - Country:US
Mailing Address - Phone:314-803-6088
Mailing Address - Fax:
Practice Address - Street 1:8011 CLAYTON RD STE 209
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-803-6088
Practice Address - Fax:314-433-5024
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010434152W00000X
MO2010020771152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1780995282Medicaid
MO064380015Medicare PIN