Provider Demographics
NPI:1033547120
Name:GARCIA, KRISTINE ASHLEY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ASHLEY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4248 BROAD HILL DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 OLD BRICK RD STE 105
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5841
Practice Address - Country:US
Practice Address - Phone:804-352-3717
Practice Address - Fax:804-552-8882
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171278363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health