Individual
MRS. KIRSTY GREAVES KANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105336
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003199400
—
FL
Enumeration date
02/12/2010
Last updated
02/24/2023
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