Provider Demographics
NPI:1902978125
Name:WATSON, KRISTINEA LYNNE
Entity Type:Individual
Prefix:MRS
First Name:KRISTINEA
Middle Name:LYNNE
Last Name:WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KRISTINEA
Other - Middle Name:LYNNE
Other - Last Name:VARGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E CAMINO DEL PINSAPO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8739
Mailing Address - Country:US
Mailing Address - Phone:520-270-5608
Mailing Address - Fax:
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4093227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered