Provider Demographics
NPI:1083017685
Name:GIORDANO, KRISTEN ELISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELISE
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:ELISE
Other - Last Name:TAORMINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8803 S 101ST EAST AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7546
Mailing Address - Country:US
Mailing Address - Phone:918-574-0220
Mailing Address - Fax:918-574-0229
Practice Address - Street 1:8803 S 101ST EAST AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7546
Practice Address - Country:US
Practice Address - Phone:918-574-0220
Practice Address - Fax:918-574-0229
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2683363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant