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General NPI Number Information
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NPI Number | 1962716803
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Entity Type | Individual
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Provider Name | KRISTI A. PRENDERGAST APRN
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Gender | Female
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N # 29055
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 904-257-3160
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Fax | 904-656-7477
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Provider Business Mailing Address
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Address Line | 61 SANDSTONE DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-0279
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Country | US
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Telephone | 419-304-4555
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Fax | 904-656-7477
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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 | ARNP9259886
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1064417
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License Number State | TX
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