Provider Demographics
NPI:1871915561
Name:VAN ATTEN-KIRETA, GERRITDINA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:GERRITDINA
Middle Name:
Last Name:VAN ATTEN-KIRETA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:GERDIEN
Other - Middle Name:
Other - Last Name:KIRETA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:812 NW 57TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6414
Mailing Address - Country:US
Mailing Address - Phone:352-519-5430
Mailing Address - Fax:352-333-6249
Practice Address - Street 1:812 NW 57TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6414
Practice Address - Country:US
Practice Address - Phone:352-519-5430
Practice Address - Fax:352-333-6249
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9179093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily