Basic Information
Provider Information
NPI: 1023083003
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LLOYD
FirstName: KRISTIN
MiddleName: VERNICE
NamePrefix: MS.
NameSuffix:  
Credential: MSPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8300 HEALTH PARK
Address2: SUITE 127
City: RALEIGH
State: NC
PostalCode: 276154730
CountryCode: US
TelephoneNumber: 9198456160
FaxNumber: 9198456188
Practice Location
Address1: 8300 HEALTH PARK
Address2: SUITE 127
City: RALEIGH
State: NC
PostalCode: 276154730
CountryCode: US
TelephoneNumber: 9198456160
FaxNumber: 9198436188
Other Information
ProviderEnumerationDate: 02/22/2006
LastUpdateDate: 04/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X9566NCN Other Service ProvidersSpecialist 
225100000X9566NCN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
2251X0800X9566NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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