Provider Demographics
NPI:1609585165
Name:SCIARRA, KRISTEN WIECK (ARNP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:WIECK
Last Name:SCIARRA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 OAKDALE LN S
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6468
Mailing Address - Country:US
Mailing Address - Phone:727-744-6480
Mailing Address - Fax:
Practice Address - Street 1:1900 OAKDALE LN S
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6468
Practice Address - Country:US
Practice Address - Phone:727-744-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023122363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health