Provider Demographics
NPI:1790158566
Name:GYRATH, KRISTEN JULIA (CRNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JULIA
Last Name:GYRATH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2901 JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2324
Mailing Address - Country:US
Mailing Address - Phone:610-272-8221
Mailing Address - Fax:610-272-5655
Practice Address - Street 1:2901 JOLLY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:610-272-8221
Practice Address - Fax:610-272-5655
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP015489363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology