Healthcare Provider Details

I. General information

NPI: 1497445902
Provider Name (Legal Business Name): KRISTI MALENA LAFEVER MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTI MALENA MANIER

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 HOSPITAL DR
GAINESBORO TN
38562-9573
US

IV. Provider business mailing address

2950 GAINESBORO HWY
BLOOMINGTON SPRINGS TN
38545-4523
US

V. Phone/Fax

Practice location:
  • Phone: 859-433-5691
  • Fax:
Mailing address:
  • Phone: 859-433-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0035868
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4002674
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000033780
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: