Doctor Name: | MS. KRISTINA GRACE HUDDLESTON |
NPI Number: | 1538478003 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S. |
License Number: | |
Business Practice Address: | 3220 Taylor Ave North Las Vegas, NV - 890307262 |
Business Phone Number: | 7024668107 |
Business Fax Number: | |
Mailing Address: | 3220 Taylor Ave, NORTH LAS VEGAS |
State: | NV |
Postal Code: | 890307262 |
Phone Number: | 7024668107 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2010 |
NPI Last Update Date: | 10/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |