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General NPI Number Information
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NPI Number | 1174137061
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Entity Type | Individual
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Provider Name | KRISTINA GATES
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Gender | Female
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 260 33RD AVE SW STE S
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City | CEDAR RAPIDS
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State | IA
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Zip | 52404-4646
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Country | US
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Telephone | 319-560-5523
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Fax | 319-403-0121
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Provider Business Mailing Address
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Address Line | 260 33RD AVE SW STE X
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City | CEDAR RAPIDS
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State | IA
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Zip | 52404-4646
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Country | US
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Telephone | 319-560-5523
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Fax | 319-403-0121
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 118238
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G160805
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License Number State | IA
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