Provider Demographics
NPI:1053549691
Name:OLIVARES, KRISTI MICHELLE (RN, MSN, PNP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:MICHELLE
Last Name:OLIVARES
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Gender:F
Credentials:RN, MSN, PNP
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Mailing Address - Street 1:1314 E SONTERRA BLVD
Mailing Address - Street 2:#5102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4278
Mailing Address - Country:US
Mailing Address - Phone:210-490-8888
Mailing Address - Fax:210-496-6865
Practice Address - Street 1:1314 E SONTERRA BLVD
Practice Address - Street 2:#5102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4278
Practice Address - Country:US
Practice Address - Phone:210-490-8888
Practice Address - Fax:210-496-6865
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2015-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX686313363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX686313OtherLISCENSE NUMBER