Healthcare Provider Details

I. General information

NPI: 1033658109
Provider Name (Legal Business Name): KRISTIN TEKOLA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 6TH AVE S 405
ST PETERSBURG FL
33701-4662
US

IV. Provider business mailing address

4749 POINTE O WOODS DR
WESLEY CHAPEL FL
33543-6940
US

V. Phone/Fax

Practice location:
  • Phone: 727-498-8994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberARNP9281343
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: