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General NPI Number Information
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NPI Number | 1164758355
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Entity Type | Individual
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Provider Name | AMY CHERYL KROSTICH CPNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2009
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 5300 W HILLSBORO BLVD. SUITE 110
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City | COCONUT CREEK
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State | FL
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Zip | 33073
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Country | US
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Telephone | 954-794-1360
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Fax | 954-794-1367
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Provider Business Mailing Address
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Address Line | 5300 W HILLSBORO BLVD. SUITE 110
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City | COCONUT CREEK
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State | FL
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Zip | 33073
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Country | US
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Telephone | 954-794-1360
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Fax | 954-794-1367
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9294385
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License Number State | FL
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