Individual
CRISTINE PALACIOS MICLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN135637
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01299571
AMERIGROUP
—
05
—
158532534B
—
GA
01
—
P00714517
RR MEDICARE
GA
Enumeration date
02/03/2009
Last updated
12/27/2016
Update your record
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