Provider Demographics
NPI:1356472781
Name:KRYDER, NORMA (FNP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:KRYDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12740 CAMINO DE LA BRECCIA
Mailing Address - Street 2:#4
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1520
Mailing Address - Country:US
Mailing Address - Phone:858-673-1266
Mailing Address - Fax:858-673-2309
Practice Address - Street 1:11770 BERNARDO PLAZA CT
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2422
Practice Address - Country:US
Practice Address - Phone:858-673-2300
Practice Address - Fax:858-673-2309
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2013-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA248665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P55102Medicare UPIN