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Individual
MRS. KRISTINE A. CERVANTES
Active
Individual
MRS. KRISTINE A. CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
030277
NY
225100000X
Physical Therapist
9026
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013X1
BCBS GROUP PROV. #
NC
01
—
079FC
BCBS INDIV PROVIDER #
NC
01
—
7211258
MEDICAID GROUP PROV. #
NC
05
—
7211438
—
NC
Enumeration date
01/22/2007
Last updated
10/01/2008
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