Provider Demographics
NPI:1881436152
Name:WYSOCKI, KRISTI (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:WYSOCKI
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 BROCKTON LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2521
Mailing Address - Country:US
Mailing Address - Phone:616-292-8396
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6801
Practice Address - Country:US
Practice Address - Phone:629-206-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach