National Provider Identifier

Kristy Lynn Shields, MSED

Kristy Lynn Shields, MSED is listed in the NPPES registry with a primary specialty of Specialist in Rochester, NY and a listed phone number of (585) 436-0362.

NPI 1205390887Rochester, NYSpecialist

Profile Overview

NPI
1205390887
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
January 28, 2019
Last Updated
January 28, 2019

Practice Location

  • 640 Jefferson Ave
  • Rochester, NY 14611-3548

Phone: (585) 436-0362

Mailing Address

  • 149 N Main St
  • Fairport, NY 14450-1434

Specialties

  • Specialist (174400000X)
Full Record
NPI
1205390887
Entity Type
Individual
Last Name
Shields
First Name
Kristy
Middle Name
Lynn
Name Prefix
Mrs.
Credential
MSED
Provider Other Last Name
Koring
Provider Other First Name
Kristy
Provider Other Last Name Type Code
1
Mailing Street Address
149 N Main St
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-1434
Mailing Country
US
Mailing Phone
(585) 377-2230
Practice Street Address
640 Jefferson Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14611-3548
Practice Country
US
Practice Phone
(585) 436-0362
Enumeration Date
January 28, 2019
Last Updated
January 28, 2019
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)
Other Identifiers
1656612 (NY, Teacher Certification)