Individual
KRISTEN ETHRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-6062
(310) 825-9820
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(323) 361-4148
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
10455
CA
363LP0200X
Pediatric Nurse Practitioner
342343
CA
Other
Enumeration date
04/07/2010
Last updated
03/17/2018
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