Individual provider · Type 1 NPI
Kristen E. Flack, AGNP
Gerontology Nurse Practitioner · Modesto, CA
NPI number
1144746140
Active
Practice location
1540 Florida Ave
Modesto, CA 95350-4430
Fax (209) 238-4890
Mailing address
1910 Customer Care Way
Atwater, CA 95301-5167
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN95078988 (CA) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | NP95007308 (CA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1144746140
Kristen E. Flack, AGNP's National Provider Identifier is 1144746140, issued on Aug 21, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Modesto, CA. The record was last updated on Sep 15, 2017.