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General NPI Number Information
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NPI Number | 1669066650
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Entity Type | Individual
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Provider Name | KRISTINE MARIE GAY APNP
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Gender | Female
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 334 S WESTERN AVE
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City | JUNEAU
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State | WI
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Zip | 53039-1163
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Country | US
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Telephone | 902-386-0290
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Fax |
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Provider Business Mailing Address
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Address Line | N2600 N KOHN RD
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City | REESEVILLE
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State | WI
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Zip | 53579-9740
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Country | US
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Telephone | 920-210-9886
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10513-33
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License Number State | WI
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