KRISTIN MARIE GARDON (NPI# 1366933608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366933608 |
| Entity Type | Individual |
| Full Name | KRISTIN MARIE GARDON |
| Credential | NP |
| Practice Address |
835 S. Van Buren St. Green Bay WI 54301 |
| Practice Telephone | 9204338586 |
| Practice Fax Number | 9208845306 |
| Mailing Telephone | 9204338586 |
| Mailing Fax Number | 9208845306 |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2019-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WW0000X |
Registered Nurse Specialization: Wound Care |
178648-30 | WI | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8502-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
835 S. VAN BUREN ST. |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760636070 | Ndidiamaka Cecilia Agu | Hospitalist | 835 S. Van Buren St., Green Bay, WI 54301-3526 | 2008-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353763 | Tiffany Dahlke | Nurse Practitioner | 2427 Bluestone Pl, Green Bay, WI 54311-6433 | 2020-03-30 |
| 1285121707 | Deanna Danelle Olk | Nurse Practitioner | 917 Lincoln St, Green Bay, WI 54303-3625 | 2018-04-19 |
| 1306221619 | Karen M Kroll | Nurse Practitioner | 1630 Commanche Ave Ste 102, Green Bay, WI 54313-5753 | 2015-07-28 |
| 1770968760 | Esmaeil Ben Kamali | Nurse Practitioner | 725 S Webster Ave Ste 201, Green Bay, WI 54301-3500 | 2015-07-20 |
| 1427338730 | Natasha M Koehler | Nurse Practitioner | 2749 E Carrera Ct, Green Bay, WI 54311-7278 | 2011-08-18 |
| 1780982397 | Seth Patrick Moore | Nurse Practitioner | 879 Mather St, Green Bay, WI 54303-3651 | 2011-03-06 |
| 1316263569 | Chris Edwin Anibal | Nurse Practitioner | 744 South Webster Avenue, Green Bay, WI 54305-3500 | 2010-04-13 |
| 1184956864 | Douglas A Bartelt | Nurse Practitioner | 464 Cardinal Lane, Green Bay, WI 54313-9569 | 2010-02-05 |
| 1750504916 | Heather Mary Weber | Nurse Practitioner | 622 Bodart St, Green Bay, WI 54301 | 2007-04-10 |
| 1346314937 | Denise Mary Brilliant | Nurse Practitioner | 2340 E Mason St, Green Bay, WI 54302-3746 | 2006-11-17 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.