Individual provider · NPI-1

Kristin Patrice Gardner, ARNP

Nurse Practitioner, Pediatrics · Daytona Beach, FL

NPI number1619512282
StatusActive
Last updated in NPPESNov 7, 2019

Details

NPI
1619512282
Entity type
Individual (NPI-1)
Name
Kristin Patrice Gardner
Credential
ARNP
Sex
Female
Sole proprietor
No
Enumeration date
Nov 7, 2019
Last updated
Nov 7, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics11003827FLYes

Practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone 386-425-4000

Mailing address

1021 Herbert St
Port Orange, FL 32129-4142

Phone 386-316-8731

Other practice locations

1021 Herbert St
Port Orange, FL 32129-4142

Phone 386-316-8731

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