Basic Information
| Provider Information | |||||||||
| NPI: | 1316271448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | KRISTINA | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 CADILLAC DR | ||||||||
| Address2: | STE. 250 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154254225 | ||||||||
| FaxNumber: | 6154254271 | ||||||||
| Practice Location | |||||||||
| Address1: | 16560 N NEBRASKA AVE | ||||||||
| Address2: | |||||||||
| City: | LUTZ | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335496172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134900909 | ||||||||
| FaxNumber: | 8134900910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2009 | ||||||||
| LastUpdateDate: | 10/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1741652 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.