Individual
TARA ELIZABETH KRISTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4704300214
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704300214
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BOARD OF NURSING
MI
Enumeration date
06/01/2018
Last updated
06/01/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up