Provider Demographics
NPI:1982931184
Name:TRANQUILLO, KRISTA ANN (ATC)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:ANN
Last Name:TRANQUILLO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:ANN
Other - Last Name:HARKENRIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:13220 S 48TH ST APT 2007
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-9000
Mailing Address - Country:US
Mailing Address - Phone:717-368-4426
Mailing Address - Fax:
Practice Address - Street 1:13220 S 48TH ST APT 2007
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-9000
Practice Address - Country:US
Practice Address - Phone:717-368-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZATR-1000902255A2300X
NY000648-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer