Provider Demographics
NPI:1619372687
Name:GC, KRISHNA (NP-FNP,TX AP125993)
Entity Type:Individual
Prefix:MR
First Name:KRISHNA
Middle Name:
Last Name:GC
Suffix:
Gender:M
Credentials:NP-FNP,TX AP125993
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 SPICEWOOD SPRINGS RD APT 225
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4354
Mailing Address - Country:US
Mailing Address - Phone:574-349-1185
Mailing Address - Fax:
Practice Address - Street 1:7950 ANDERSON SQUARE SUITE 108
Practice Address - Street 2:225
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757
Practice Address - Country:US
Practice Address - Phone:512-296-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP 125993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily