Healthcare Provider Details

I. General information

NPI: 1386676021
Provider Name (Legal Business Name): KRISTINE ANN GARVERICK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINE ANN PUCHALSKI CRNP

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S WASHINGTON ST SUITE B
GETTYSBURG PA
17325-2500
US

IV. Provider business mailing address

1803 MOUNT ROSE AVE SUITE B3
YORK PA
17403-3026
US

V. Phone/Fax

Practice location:
  • Phone: 717-337-4492
  • Fax: 717-337-4324
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberTP005724C
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: