Provider Demographics
NPI:1386032761
Name:GOLDEN, KRISTIN J (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:J
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:J
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1219 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:IA
Mailing Address - Zip Code:51640-1300
Mailing Address - Country:US
Mailing Address - Phone:712-382-2626
Mailing Address - Fax:712-382-1931
Practice Address - Street 1:710 CENTER ST
Practice Address - Street 2:
Practice Address - City:TABOR
Practice Address - State:IA
Practice Address - Zip Code:51653-2069
Practice Address - Country:US
Practice Address - Phone:712-629-2975
Practice Address - Fax:712-629-5325
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA138798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily