Provider Demographics
NPI:1386676021
Name:GARVERICK, KRISTINE ANN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:ANN
Last Name:GARVERICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:ANN
Other - Last Name:PUCHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:450 S WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2500
Practice Address - Country:US
Practice Address - Phone:717-337-4492
Practice Address - Fax:717-337-4324
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005724C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50018453OtherCAPITAL BLUE CROSS-WMG
PA105163OtherJOHNS HOPKINS
PA1551701OtherGATEWAY-WMG
PA1916410OtherHIGHMARK BLUE SHIELD
MD61901002OtherCAREFIRST MD BCBS
PA50018453OtherCAPITAL BLUE CROSS-WMG
MD61901002OtherCAREFIRST MD BCBS
PA040495FLTMedicare PIN