Provider Demographics
NPI:1801237821
Name:GETZLAFF, KRISTEN (BSN, RN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:GETZLAFF
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 TOWER PL
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3244
Mailing Address - Country:US
Mailing Address - Phone:701-989-4354
Mailing Address - Fax:701-425-0104
Practice Address - Street 1:3100 MOONSTONE LN
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6308
Practice Address - Country:US
Practice Address - Phone:701-989-4354
Practice Address - Fax:701-425-0104
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33603163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse