Provider Demographics
NPI:1881415230
Name:NOZIERE, KRISTINA J
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:J
Last Name:NOZIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 NE 17TH WAY UNIT 504
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2480
Mailing Address - Country:US
Mailing Address - Phone:678-650-6061
Mailing Address - Fax:
Practice Address - Street 1:1033 NE 17TH WAY UNIT 504
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-2480
Practice Address - Country:US
Practice Address - Phone:678-650-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036075363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health