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Individual

KRISTEN LEE NORTHERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-BC

Contact information

Practice address
1001 HEWITT DR, WACO, TX 76712-8486
(254) 202-7800
Mailing address
PO BOX 848476, DALLAS, TX 75284-8476
(254) 202-4655
(254) 202-4697

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
701980
TX
363L00000X
Nurse Practitioner
Primary
AP119284
TX
363LF0000X
Family Nurse Practitioner
701980
TX

Other

Enumeration date
03/22/2011
Last updated
01/07/2021
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