Provider Demographics
NPI:1770966335
Name:GARCIA-MILLER, KRISTIN ANN (AG-ACNP, CEN)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ANN
Last Name:GARCIA-MILLER
Suffix:
Gender:F
Credentials:AG-ACNP, CEN
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:ANN
Other - Last Name:GARCIA AND/OR GANTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AG-ACNP
Mailing Address - Street 1:2484 CARING WAY
Mailing Address - Street 2:UNIT F
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5306
Mailing Address - Country:US
Mailing Address - Phone:941-246-2482
Mailing Address - Fax:941-979-9074
Practice Address - Street 1:2484 CARING WAY
Practice Address - Street 2:UNIT F
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5306
Practice Address - Country:US
Practice Address - Phone:941-246-2482
Practice Address - Fax:941-979-9074
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9182941363LG0600X, 363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner