Provider Demographics
NPI:1437107943
Name:KRISTOFERSDOTTIR, GUDRUN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:GUDRUN
Middle Name:
Last Name:KRISTOFERSDOTTIR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 FOX RUN CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-1829
Mailing Address - Country:US
Mailing Address - Phone:405-315-6363
Mailing Address - Fax:
Practice Address - Street 1:260 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:TEQUEST
Practice Address - State:FL
Practice Address - Zip Code:33469
Practice Address - Country:US
Practice Address - Phone:561-874-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9229457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily