Provider Demographics
NPI:1467127845
Name:GURULE, KRISTA JOLENE (NP-C)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:JOLENE
Last Name:GURULE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6016 KILMER AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1410
Mailing Address - Country:US
Mailing Address - Phone:505-681-5287
Mailing Address - Fax:
Practice Address - Street 1:6016 KILMER AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1410
Practice Address - Country:US
Practice Address - Phone:505-681-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM64739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily