Deanna Jane Kristofic, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4267 Issued in AZ

Practice address

167 North Main Street
Tuba City, AZ 86045-0600

Phone

(928) 283-2501

NPI assigned

Apr 19, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Deanna Jane Thompson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1013207489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 ABLE AVE",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847418161",
            "telephone_number": "928-640-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTOFIC",
        "first_name": "DEANNA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "THOMPSON",
            "middle_name": "JANE",
            "prefix": "MS.",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela L. Kiyaani, HT
• Doreen Kiyaani, HT
• Susan Christine Knisely, R.N.
• Srinija Konduru, M.D.
• Ling-Ann Koshok, RN
• Lisa Michelle Kuntz, RN
• Mark Labash, PHARM.D.,RPH
• Gary Bradley Lake, MD
• Lorrie Ann Lake, RN
• Julia Lam, PHARM.D.

• Psychiatric/Mental Health Nurse Practitioner in Tuba City, AZ
• Providers in Tuba City, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.