Provider Demographics
NPI:1801110234
Name:ALSTON, KRISTY L (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:L
Last Name:ALSTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4020
Mailing Address - Country:US
Mailing Address - Phone:562-862-3684
Mailing Address - Fax:562-923-9758
Practice Address - Street 1:10000 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4020
Practice Address - Country:US
Practice Address - Phone:562-862-3684
Practice Address - Fax:562-923-9758
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3886363LF0000X
CA19329363LF0000X, 363LF0000X
VA0024170368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily