Provider Demographics
NPI:1053797803
Name:PARKINSON, KRISTINA LYNN (CPNP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LYNN
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W 71ST ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3731
Mailing Address - Country:US
Mailing Address - Phone:732-232-7617
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST PH 17
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-5462
Practice Address - Fax:212-342-5736
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197734163WP0200X, 363LP0200X
NY382725363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics