Provider Demographics
NPI:1952159998
Name:SEMONICK, KRISTINA RAE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:RAE
Last Name:SEMONICK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:KRISTINA
Other - Middle Name:RAE
Other - Last Name:FOLLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 PHILOSOPHERS TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1715
Mailing Address - Country:US
Mailing Address - Phone:443-215-5353
Mailing Address - Fax:833-615-2165
Practice Address - Street 1:126 PHILOSOPHERS TER
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1715
Practice Address - Country:US
Practice Address - Phone:443-215-5353
Practice Address - Fax:833-615-2165
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201890363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner