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General NPI Number Information
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NPI Number | 1043403512
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Entity Type | Individual
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Provider Name | KRISTINE FREE LPN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2007
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Last Update Date | 08/19/2007
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Provider Practice Location Address
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Address Line | 100 W CYPRESS CREEK RD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2181
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Country | US
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Telephone | 954-351-9303
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 NW 78TH AVE
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City | PLANTATION
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State | FL
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Zip | 33322-5161
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Country | US
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Telephone | 954-882-0678
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5154253
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License Number State | FL
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