| NPI | 1821735424 |
|---|---|
| Former Name | KRISTINE T GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 255977) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 255977) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2025-01-16 |