Individual
MRS. KRISTIN MARIE THEETGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1010 W LA VETA AVE STE 610, ORANGE, CA 92868-4306
(714) 285-2311
(714) 285-2319
Mailing address
1010 W LA VETA AVE STE 610, ORANGE, CA 92868-4306
(714) 285-2311
(714) 285-2319
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
16619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
639048
REGISTERED NURSE LICENSE
CA
Enumeration date
03/05/2007
Last updated
02/21/2012
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