Provider Demographics
NPI:1659266237
Name:PATEL, KRISHAN (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISHAN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 N BIG CYPRESS DR APT 351
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-1963
Mailing Address - Country:US
Mailing Address - Phone:408-836-6726
Mailing Address - Fax:
Practice Address - Street 1:130 N BIG CYPRESS DR APT 351
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-1963
Practice Address - Country:US
Practice Address - Phone:408-836-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040134363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily