Provider Demographics
NPI:1518041250
Name:GIEMZA, KRISTI (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:GIEMZA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2024
Mailing Address - Country:US
Mailing Address - Phone:919-433-1520
Mailing Address - Fax:
Practice Address - Street 1:1820 JAMES ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2024
Practice Address - Country:US
Practice Address - Phone:919-433-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S52025Medicare ID - Type Unspecified
NC2592135Medicare ID - Type Unspecified