Provider Demographics
NPI:1043726904
Name:AGRANAT, KRISTINA (ARNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:AGRANAT
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:AGRANAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:3100 S TAMIAMI TRL STE B
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5139
Mailing Address - Country:US
Mailing Address - Phone:419-917-8185
Mailing Address - Fax:941-917-8085
Practice Address - Street 1:3100 S TAMIAMI TRL STE B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5139
Practice Address - Country:US
Practice Address - Phone:419-917-8185
Practice Address - Fax:941-917-8085
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9320954363LF0000X
CT8883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily