MEDICARE: KRISTI MASSEY FNP-C

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
1	363LF0000X	Family Nurse Practitioner	F06141066	NC

General Provider Information

NPI Number	:	1639585102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI MASSEY FNP-C

Provider Business Mailing Address
First Line	:	348 N SOUTH ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-3532
Country	:	US
Telephone Number	:	910-389-0109
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 N SOUTH ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-3532
Country	:	US
Telephone Number	:	910-389-0109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2014
Last Update Date	:	10/21/2016

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Directions to “ KRISTI MASSEY FNP-C” Practice Location

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