Healthcare Provider Details

I. General information

NPI: 1992626170
Provider Name (Legal Business Name): KRISTA CARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 PROSPECT TRAIL
ST. CLOUD FL
34771
US

IV. Provider business mailing address

3040 PROSPECT TRAIL
ST. CLOUD FL
34771
US

V. Phone/Fax

Practice location:
  • Phone: 907-250-3501
  • Fax: 907-250-3501
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN9582288
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: