Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024171278 | VA |
NPI | 1033547120 |
---|---|
Provider Name | Kristine Ashley Garcia |
First Address | Glen Allen, VA 23059-5541 |
Second Address | Richmond, VA 23230-3033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2013 |
Last Update Date | 08/01/2021 |