Healthcare Provider Details

I. General information

NPI: 1164096541
Provider Name (Legal Business Name): KRISTINA RISOLA CRC, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5486 WAYCROSS DR
SPRING HILL FL
34606-4645
US

IV. Provider business mailing address

5486 WAYCROSS DR
SPRING HILL FL
34606-4645
US

V. Phone/Fax

Practice location:
  • Phone: 352-942-7027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: