Doctor Name: | KRISTI L VIA |
NPI Number: | 1164428108 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | AP113118 |
Business Practice Address: | 3126 W Fm 120 Denison, TX - 750201249 |
Business Phone Number: | 9034167544 |
Business Fax Number: | 9034167545 |
Mailing Address: | Po Box 844707, Attn: Ipm Credentialing DALLAS |
State: | TX |
Postal Code: | 752844707 |
Phone Number: | 9034161726 |
Fax Number: | 9034161701 |
NPI Enumeration Date: | 06/23/2005 |
NPI Last Update Date: | 11/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP113118 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |