Provider Demographics
NPI:1750198172
Name:GARCIA, KRISTA ANNE
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:ANNE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3527
Mailing Address - Country:US
Mailing Address - Phone:978-257-2100
Mailing Address - Fax:
Practice Address - Street 1:3 MELODY LN
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-3527
Practice Address - Country:US
Practice Address - Phone:978-257-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH063411-21163W00000X
MARN2267679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse