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NPI Code Detail

MEDICARE: MS. KRISTINA LYNN CREININ ATC, LAT, CES

MEDICARE:  MS. KRISTINA LYNN CREININ  ATC, LAT, CES
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
12255A2300XAthletic TrainerAL3384FL

General Provider Information

NPI Number : 1922384361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTINA LYNN CREININ ATC, LAT, CES
Provider Business Mailing Address
First Line : 2334 NORWOOD PL
Second Line :
City : TAVARES
State : FL
Zip : 32778-5102
Country : US
Telephone Number : 407-462-4424
Fax Number :
Provider Business Practice Location Address
First Line : 1925 DON WICKHAM DR
Second Line :
City : CLERMONT
State : FL
Zip : 34711-1915
Country : US
Telephone Number : 352-404-8956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 01/07/2015

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Directions to “ MS. KRISTINA LYNN CREININ ATC, LAT, CES” Practice Location

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