Healthcare Provider Details

I. General information

NPI: 1477487510
Provider Name (Legal Business Name): KRYSTEN NICOLLE FLOYD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 HOLME AVE
PHILADELPHIA PA
19152-2096
US

IV. Provider business mailing address

1901 CALLOWHILL ST APT 728
PHILADELPHIA PA
19130-4158
US

V. Phone/Fax

Practice location:
  • Phone: 215-300-4016
  • Fax:
Mailing address:
  • Phone: 772-539-1459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMT238187
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: