Provider Demographics
NPI:1194078501
Name:BUYS, KRISTIN K (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:BUYS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 PARADISE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84028
Mailing Address - Country:US
Mailing Address - Phone:435-255-1630
Mailing Address - Fax:435-946-9124
Practice Address - Street 1:288 S PARADISE PARKWAY
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:UT
Practice Address - Zip Code:84028
Practice Address - Country:US
Practice Address - Phone:435-255-1630
Practice Address - Fax:435-946-9124
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA-1511363AM0700X
UT8461958-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical