MEDICARE: KRISTY LYNN KIRONDE 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	200950090NP	OR

General Provider Information

NPI Number	:	1679895783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY LYNN KIRONDE FNP

Provider Business Mailing Address
First Line	:	28047 SANTIAM HWY
Second Line	:
City	:	SWEET HOME
State	:	OR
Zip	:	97386-9722
Country	:	US
Telephone Number	:	541-367-5090
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 14TH AVE SE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97322-8502
Country	:	US
Telephone Number	:	541-754-1369
Fax Number	:	844-423-9573

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

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	03/15/2019

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