Individual
KRISTEN LEIGH HERISTCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, PAC, CAQ-PSYCH
Contact information
Practice address
1801 CRYSTAL LAKE DR, LAKELAND, FL 33801-5979
(863) 709-8543
Mailing address
6961 INDIAN CREEK PARK DR, LAKELAND, FL 33813-3833
(863) 397-4259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA910207
FL
363AM0700X
Medical Physician Assistant
Primary
PA910207
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E8856Y
MEDICARE
FL
Enumeration date
12/01/2005
Last updated
04/07/2026
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