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NPI Code Detail

MEDICARE: KRISTY EAST PRSS

MEDICARE:   KRISTY  EAST  PRSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist22-964WV

General Provider Information

NPI Number : 1255032546
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY EAST PRSS
Provider Business Mailing Address
First Line : 106 THORN ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-3560
Country : US
Telephone Number : 304-314-7501
Fax Number : 304-936-6156
Provider Business Practice Location Address
First Line : 106 THORN ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-3560
Country : US
Telephone Number : 304-314-7501
Fax Number : 304-936-6156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2023
Last Update Date : 03/14/2023

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Directions to “ KRISTY EAST PRSS” Practice Location

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