Provider Demographics
NPI:1043701352
Name:DEFLURI, KRISTY LYNN (MSN, CRNA)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LYNN
Last Name:DEFLURI
Suffix:
Gender:F
Credentials:MSN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PORT RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6726
Mailing Address - Country:US
Mailing Address - Phone:908-208-9465
Mailing Address - Fax:
Practice Address - Street 1:360 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5823
Practice Address - Country:US
Practice Address - Phone:732-942-9835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14394300163WC0200X
NJ26NJ00829900367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine