Provider Demographics
NPI:1861052953
Name:ESENWEIN, KRISTIN N (FNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:N
Last Name:ESENWEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 E LEE ST STE B
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2477
Mailing Address - Country:US
Mailing Address - Phone:334-794-2718
Mailing Address - Fax:
Practice Address - Street 1:805 E LEE ST STE B
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2477
Practice Address - Country:US
Practice Address - Phone:334-794-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002660363LF0000X
AL1-181535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily