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Individual

KRISTYN LINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
555 W STATE ROAD 434, LONGWOOD, FL 32750-5119
(321) 842-2994
(407) 767-5801
Mailing address
555 W STATE ROAD 434, LONGWOOD, FL 32750-5119
(321) 842-2994
(407) 767-5801

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9315039
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9315039
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016505200
FL
Enumeration date
12/31/2015
Last updated
03/17/2018
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