Provider Demographics
NPI:1215268701
Name:TINGLE, KRISTI LEIGH (WHNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LEIGH
Last Name:TINGLE
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Gender:F
Credentials:WHNP-C
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Mailing Address - Street 1:2700 STANLEY GAULT PKWY
Mailing Address - Street 2:SUITE 129
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5132
Mailing Address - Country:US
Mailing Address - Phone:502-253-4917
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:1023 NEW MOODY LN
Practice Address - Street 2:STE 103
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9177
Practice Address - Country:US
Practice Address - Phone:502-222-5558
Practice Address - Fax:502-222-3040
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2020-12-03
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Provider Licenses
StateLicense IDTaxonomies
KY6257P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100261810Medicaid