1669817631 NPI number — MRS. KRISTI LASHUN HAND NP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669817631 NPI number — MRS. KRISTI LASHUN HAND NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAND
Provider First Name:
KRISTI
Provider Middle Name:
LASHUN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DENNIS
Provider Other First Name:
KRISTI
Provider Other Middle Name:
LASHUN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669817631
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8390 CHAMPIONS GATE BLVD
Provider Second Line Business Mailing Address:
SUITE 215
Provider Business Mailing Address City Name:
CHAMPIONS GATE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33896-8310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-390-1677
Provider Business Mailing Address Fax Number:
407-390-1765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
770 GRIESON TRAIL
Provider Second Line Business Practice Location Address:
SUITE H
Provider Business Practice Location Address City Name:
NEWNAN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30263-6408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-252-5420
Provider Business Practice Location Address Fax Number:
770-252-5421
Provider Enumeration Date:
05/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN177312 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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