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General NPI Number Information
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NPI Number | 1083594956
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Entity Type | Individual
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Provider Name | KRISTEN MASSEY
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 500 INDIANA AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2169
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Country | US
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Telephone | 928-289-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 3120 N NANCY DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-0913
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 169916
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License Number State | AZ
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