MEDICARE: KRISTINA M. PARKIN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00480500	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6P3300	OTHER	NJ	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144641739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA M. PARKIN FNP

Provider Business Mailing Address
First Line	:	200 HYGEIA DR
Second Line	:	CCHS PHYSICIAN CONTRACTING, SUITE 2300
City	:	NEWARK
State	:	DE
Zip	:	19713-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 EAST AVE
Second Line	:	SUITE C
City	:	WOODSTOWN
State	:	NJ
Zip	:	08098-1351
Country	:	US
Telephone Number	:	856-769-2800
Fax Number	:	856-769-4256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2013
Last Update Date	:	06/24/2024

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