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NPI Code Detail

MEDICARE: MRS. KRISTEN NICOLE VACINEK APRN

MEDICARE: MRS. KRISTEN NICOLE VACINEK APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN256792GA

General Provider Information

NPI Number : 1558931188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN NICOLE VACINEK APRN
Provider Business Mailing Address
First Line : 4110 MANTLE RIDGE DR
Second Line :
City : CUMMING
State : GA
Zip : 30041-5652
Country : US
Telephone Number : 404-394-9755
Fax Number :
Provider Business Practice Location Address
First Line : 6335 HOSPITAL PKWY STE 304
Second Line :
City : DULUTH
State : GA
Zip : 30097-5712
Country : US
Telephone Number : 404-778-8311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2021
Last Update Date : 10/10/2025

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Directions to “ MRS. KRISTEN NICOLE VACINEK APRN” Practice Location

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