Individual
KRISTINA M. CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2900 1ST AVE, ROOM 1025, HUNTINGTON, WV 25702-1241
(304) 399-7484
(304) 399-7579
Mailing address
PO BOX 88, 5 E ALVON ROAD SUITE 7, WHITE SULPHUR SPRINGS, WV 24986-2373
(304) 536-5030
(304) 536-5031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
43022
WV
363LP2300X
Primary Care Nurse Practitioner
43022
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2772790
—
OH
05
—
7100123630
—
KY
05
—
7101002000
—
WV
01
—
P00851933
RR MEDICARE
WV
Enumeration date
06/18/2007
Last updated
02/28/2014
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