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General NPI Number Information
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NPI Number | 1790147304
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Entity Type | Individual
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Provider Name | KRISTIN HEXTALL
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Gender | Female
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1916 ROUTE 70 E STE 4
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2139
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Country | US
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Telephone | 856-230-7684
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Fax | 856-249-9427
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Provider Business Mailing Address
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Address Line | 1916 ROUTE 70 E STE 4
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2139
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Country | US
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Telephone | 856-230-7684
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Fax | 856-249-9427
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015344
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License Number State | PA
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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 | 26NJ00626300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN603891
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR17986800
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License Number State | NJ
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