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General NPI Number Information
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NPI Number | 1023667516
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Entity Type | Individual
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Provider Name | KRISTI M LORD APRN
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Gender | Female
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 9190 AUGUST CIR
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-8626
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Country | US
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Telephone | 352-650-3446
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Fax | 904-341-5529
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Provider Business Mailing Address
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Address Line | 9190 AUGUST CIR
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-8626
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Country | US
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Telephone | 352-650-3446
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Fax | 904-341-5529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 11004025
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11004025
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License Number State | FL
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