Provider Demographics
NPI:1831922301
Name:KLEINSCHMIDT, KRIESTIN LYNETTE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:KRIESTIN
Middle Name:LYNETTE
Last Name:KLEINSCHMIDT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 ROCK MERRITT RD
Mailing Address - Street 2:
Mailing Address - City:FT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28394
Mailing Address - Country:US
Mailing Address - Phone:910-908-2264
Mailing Address - Fax:910-907-6317
Practice Address - Street 1:2817 ROCK MERRITT RD
Practice Address - Street 2:
Practice Address - City:FT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28394
Practice Address - Country:US
Practice Address - Phone:910-908-2264
Practice Address - Fax:910-907-6317
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183365163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management