Provider Demographics
NPI:1215935556
Name:MCINTEE, KRISTINE MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:MCINTEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:GARETSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, SM
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-4241
Mailing Address - Fax:319-356-3086
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-4241
Practice Address - Fax:319-356-3086
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2979772363LF0000X
IA059569363LF0000X
IAH059569363LP0200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0076372Medicaid
FL306077200Medicaid
FLE5247X-E5247WMedicare ID - Type Unspecified
P27386Medicare UPIN