KRISTA LEIGH PETRY (NPI# 1487118782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487118782 |
| Entity Type | Individual |
| Full Name | KRISTA LEIGH PETRY |
| Other Name | KRISTA LEIGH JOHNSON |
| Credential | FNP |
| Practice Address |
4720 Baker St Lakewood NY 14750-9772 |
| Practice Telephone | 7164562149 |
| Mailing Telephone | 7164562149 |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
343971 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4720 BAKER ST |
| City | LAKEWOOD |
| State | NY |
| Zip Code | 14750-9772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699163147 | Craig Richards | Physician Assistant | 390 E Fairmount Ave, Lakewood, NY 14750 | 2015-01-07 |
| 1982849659 | Syed Ali Raza Shamsi | Psychiatry & Neurology | 305 E. Fairmont Avenue, Unit 7, Lakewood, NY 14750 | 2008-12-10 |
| 1942417977 | Stephen C Barresi | Physician Assistant | Chd Meridian Healthcare, Jep, 4720 Bakerst, Ext., Lakewood, NY 14750 | 2007-05-17 |
| 1295947117 | Harold Ronald Carlson | Dentist | 2 East Main Street, Suite 115, Falconer, NY 14750 | 2007-05-04 |
| 1194865907 | David William Todd | Dentist | 120 Southwestern Dr, Lakewood, NY 14750 | 2007-02-08 |
| 1730271248 | Lee Ryan Anderson | Dentist | 909 Hunt Road, Lakewood, NY 14750 | 2006-09-29 |
| 1962416362 | Us Vision Optical Inc | Eyewear Supplier (Equipment, not the service) | Rt 394 Mall Blvd, Lakewood, NY 14750 | 2006-07-28 |
| 1518925437 | Israr A Abbasi | Psychiatry & Neurology | 305 E Fairmount Ave, Lakewood, NY 14750 | 2006-05-02 |
| 1992771190 | Robert Gibbon Jr. | Psychiatry & Neurology | 92 W. Summit St., Lakewood, NY 14750 | 2006-02-27 |
| 1295213684 | Allison Claire Munella | Physician Assistant | 305 E Fairmount Ave, Lakewood, NY 14750 | 2018-07-30 |
| Find all providers in zip 14750 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218574 | Primary Health Services LLC | Nurse Practitioner | 500 River Ave Ste 200, Lakewood, NJ 08701-4719 | 2020-09-01 |
| 1235748237 | Esther Steinhaus | Nurse Practitioner | 409 Ashley Ave, Lakewood, NJ 08701-4866 | 2020-07-26 |
| 1609402817 | Bridgit V Wedgle | Nurse Practitioner | 2556 S Jellison Ct, Lakewood, CO 80227-2872 | 2020-03-19 |
| 1255963187 | Tresa Marie Glaser | Nurse Practitioner | 8807 25th Ave S, Lakewood, WA 98499-8301 | 2020-02-08 |
| 1972149490 | Richard Allan Coronel Sy | Nurse Practitioner | 11645 Walcroft St, Lakewood, CA 90715-1356 | 2019-11-19 |
| 1609411867 | Jennifer Lynn Wondel | Nurse Practitioner | 10424 W Arkansas Dr, Lakewood, CO 80232-5014 | 2019-11-12 |
| 1457901555 | Nancy Wairimu Minjire | Nurse Practitioner | 9537 Gravelly Lake Dr Sw # E10, Lakewood, WA 98499-1513 | 2019-09-19 |
| 1619432325 | Soroh Neuberger | Nurse Practitioner | 232 Jamescrest Ct, Lakewood, NJ 08701-4708 | 2019-02-06 |
| 1649740093 | Svetlana Polyakova | Nurse Practitioner | 8316 W Eastman Pl, Lakewood, CO 80227-6240 | 2018-11-28 |
| 1265946891 | Mary Lee Matulis | Nurse Practitioner | 7120 W Warren Ave, Lakewood, CO 80227-2611 | 2017-11-17 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.