Individual
CRISTINA HELENA VERGARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 GREENCASTLE RD, TYRONE, GA 30290-2936
(949) 680-9132
Mailing address
190 GREENCASTLE RD, TYRONE, GA 30290-2936
(949) 680-9132
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN268443
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN268443
GA
Other
Enumeration date
10/21/2019
Last updated
01/13/2022
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