MEDICARE: KRISTY SHIRLA GINTZ AGNP

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
1	363LA2200X	Adult Health Nurse Practitioner	AP11132	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750886107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY SHIRLA GINTZ AGNP

Provider Business Mailing Address
First Line	:	7843 W SPINEY LIZARD PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85735-5199
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7620 N HARTMAN LN STE 180B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-7485
Country	:	US
Telephone Number	:	520-614-6326
Fax Number	:	520-542-2911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	10/01/2024

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