Provider Demographics
NPI:1487663886
Name:GARNER, KRISTA MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARIE
Last Name:GARNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 CROSSGATE CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2293
Mailing Address - Country:US
Mailing Address - Phone:770-466-8006
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE STE B2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-712-1984
Practice Address - Fax:404-712-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR128220363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine