Provider Demographics
NPI:1871125054
Name:PLATT, KRISTAL (LCGC)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:BOYS TOWN NATIONAL RESEARCH HOSPITAL
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:531-355-6365
Mailing Address - Fax:531-355-5028
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:BOYS TOWN NATIONAL RESEARCH HOSPITAL
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:531-355-6365
Practice Address - Fax:531-355-5028
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE16170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS