Provider Demographics
NPI:1730539701
Name:GLASER, KRISTINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:GLASER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:MCMICAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1699 SW 16TH AVE BLDG A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1158
Mailing Address - Country:US
Mailing Address - Phone:352-334-0206
Mailing Address - Fax:
Practice Address - Street 1:1699 SW 16TH AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1158
Practice Address - Country:US
Practice Address - Phone:352-334-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9315061163W00000X
FLARNP 9315061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018466800Medicaid
FL018466800Medicaid