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NPI Code Detail

MEDICARE: MS. KRISTI RENEE SHIVER NP-C

MEDICARE: MS. KRISTI RENEE SHIVER NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN177287GA

General Provider Information

NPI Number : 1184853046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTI RENEE SHIVER NP-C
Provider Business Mailing Address
First Line : 55 WHITCHER ST NE STE 350
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1129
Country : US
Telephone Number : 770-424-6893
Fax Number : 770-528-9938
Provider Business Practice Location Address
First Line : 55 WHITCHER ST NE STE 350
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1129
Country : US
Telephone Number : 770-424-6893
Fax Number : 770-528-9938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2009
Last Update Date : 08/17/2021

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