| Doctor Name: | MRS. KIMBERLY KAE CRIST |
| NPI Number: | 1134392350 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPN |
| License Number: | 0006952-14675 |
| Business Practice Address: | 28647 Hwy 92 Bagley, MN - 56621 |
| Business Phone Number: | 2186943049 |
| Business Fax Number: | 2187852707 |
| Mailing Address: | 34666 Rock Ridge Rd, BAGLEY |
| State: | MN |
| Postal Code: | 566214214 |
| Phone Number: | 2186943049 |
| Fax Number: | 2187852707 |
| NPI Enumeration Date: | 04/09/2008 |
| NPI Last Update Date: | 04/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 177F00000X |
| License Number: | 0006952-14675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Lodging |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |