Provider Demographics
NPI:1861908469
Name:WEBSTER, KRISTEN BROOKE (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BROOKE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MULBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2277
Mailing Address - Country:US
Mailing Address - Phone:954-274-8989
Mailing Address - Fax:
Practice Address - Street 1:117 MULBERRY CIR
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2277
Practice Address - Country:US
Practice Address - Phone:954-274-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9389402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily