Provider Demographics
NPI:1043032592
Name:CADY, KRISTIN (LPN, NBC-HWC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CADY
Suffix:
Gender:F
Credentials:LPN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11580 PIERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-4130
Mailing Address - Country:US
Mailing Address - Phone:814-853-8351
Mailing Address - Fax:
Practice Address - Street 1:11580 PIERSON AVE
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4130
Practice Address - Country:US
Practice Address - Phone:814-853-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAA-3786004171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach