Provider Demographics
NPI:1114387784
Name:HAIGHT, KRISTYN (PA)
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:L
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:710 W WATERLOO ST
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1092
Mailing Address - Country:US
Mailing Address - Phone:614-321-2581
Mailing Address - Fax:
Practice Address - Street 1:710 W WATERLOO ST
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-1092
Practice Address - Country:US
Practice Address - Phone:614-321-2581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50004457363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant