Individual
FRISTANTO KURNIAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
9250 PINECROFT DR, SHENANDOAH, TX 77380-3218
(713) 897-2300
Mailing address
1111 MEDICAL PLAZA DR STE 250, THE WOODLANDS, TX 77380-3477
(281) 296-8788
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1006744
TX
Other
Enumeration date
08/17/2020
Last updated
07/05/2022
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