Provider Demographics
NPI:1063663946
Name:GRMELA, KRISTEEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEEN
Middle Name:ELIZABETH
Last Name:GRMELA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTEEN
Other - Middle Name:ELIZABETH
Other - Last Name:PELKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:1600 COIT RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6174
Mailing Address - Country:US
Mailing Address - Phone:972-612-8829
Mailing Address - Fax:972-612-2875
Practice Address - Street 1:4716 ALLIANCE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5554
Practice Address - Country:US
Practice Address - Phone:469-800-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant