Provider Demographics
NPI:1831994425
Name:MOEN, KRISTINA (PMHNP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MOEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 TROOST AVE UNIT 325
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-3493
Mailing Address - Country:US
Mailing Address - Phone:573-353-3398
Mailing Address - Fax:
Practice Address - Street 1:2501 TROOST AVE UNIT 325
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-3493
Practice Address - Country:US
Practice Address - Phone:573-353-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250040752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry