Provider Demographics
NPI:1952950560
Name:GIACOMIN, KRISTEN M (NP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:GIACOMIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 E 90TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7160
Mailing Address - Country:US
Mailing Address - Phone:219-736-2922
Mailing Address - Fax:219-736-2938
Practice Address - Street 1:118 E 90TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7160
Practice Address - Country:US
Practice Address - Phone:219-736-2922
Practice Address - Fax:219-736-2938
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009297A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily