Provider Demographics
NPI:1740768316
Name:GISH, KRISTINA ARTHUR (RN, BSN, BS)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ARTHUR
Last Name:GISH
Suffix:
Gender:F
Credentials:RN, BSN, BS
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:KAY
Other - Last Name:ARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 ROLLING LN
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2733
Mailing Address - Country:US
Mailing Address - Phone:978-729-1493
Mailing Address - Fax:
Practice Address - Street 1:35 ROLLING LN
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2733
Practice Address - Country:US
Practice Address - Phone:978-729-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-05
Last Update Date:2018-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN184342163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse