KRISTINE ANDERSON WATERS (NPI# 1053685354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053685354 |
| Entity Type | Individual |
| Full Name | KRISTINE ANDERSON WATERS |
| Credential | PA-C |
| Practice Address |
105 Southpark Blvd Ste A103 St Augustine FL 32086-4162 |
| Mailing Address |
14164 Mahogany Ave Jacksonville FL 32258-5513 |
| Practice Telephone | 9043427765 |
| Mailing Telephone | 9046549892 |
| Enumeration Date | 2012-03-04 |
| Last Update Date | 2016-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9106439 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124378575 | Kristine Waters | Marriage & Family Therapist | 1236 Paris Pike, Georgetown, KY 40324-9701 | 2012-09-13 |
| Street Address |
105 SOUTHPARK BLVD STE A103 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-4162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114323490 | Neda Ruth Kadkhodaie | Physician Assistant | 2676 Us 1 S, St Augustine, FL 32086-6191 | 2014-11-13 |
| 1497021059 | Ralph David Priddy | Physician Assistant | 2305 State Road 207, St Augustine, FL 32086-9329 | 2012-03-28 |
| 1437275880 | Richard A Oldano | Physician Assistant | 1300 Barrington Cir, St Augustine, FL 32092-3612 | 2007-03-21 |
| 1104978287 | Brent Davin Hopson | Physician Assistant | 3100 Us 1 S, St Augustine, FL 32086 | 2007-01-17 |
| 1538134721 | Jarrod D Roussel | Physician Assistant | 1 Orthopaedic Pl, St Augustine, FL 32086-4202 | 2006-02-21 |
| 1316946866 | Victoria O Miller | Physician Assistant | 493 Prosperity Lake Dr, St Augustine, FL 32092-5045 | 2005-07-18 |
| 1952912826 | Megan Burke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2020-08-13 |
| 1508416991 | Ashley Jarriel Gucwa | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2019-09-17 |
| 1750804662 | Gabrielle Du Sablon | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-23 |
| 1952838898 | Beau Brian Nacke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-05-22 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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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.