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General NPI Number Information
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NPI Number | 1073222691
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Entity Type | Individual
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Provider Name | KRISTINE A WHITCOMB CHW, CPRS
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Gender | Female
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 742 CLEVELAND AVENUE SE APT 104
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City | HUTCHINSON
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State | MN
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Zip | 55350-5535
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Country | US
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Telephone | 320-298-6778
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Fax |
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Provider Business Mailing Address
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Address Line | 520 CHANDLER AVE N
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City | GLENCOE
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State | MN
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Zip | 55336-2823
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Country | US
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Telephone | 320-510-1993
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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