Individual provider · Type 1 NPI
Kristan Probeck, RN, MS, ANP
Adult Health Nurse Practitioner · Medford, NY
NPI number
1780944363
Active
Practice location
1743 North Ocean Ave
Medford, NY 11763
Mailing address
100 Nicholls Rd, Hsc 19-090 Department Of Vascular Surgery
Stony Brook, NY 11794-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 544021 (NY) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 30 305525 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1780944363
Kristan Probeck, RN, MS, ANP's National Provider Identifier is 1780944363, issued on May 17, 2012. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Medford, NY. The record was last updated on Mar 1, 2016.