Provider Demographics
NPI:1386173490
Name:MARTIN, KRISTEN (PA)
Entity type:Individual
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First Name:KRISTEN
Middle Name:
Last Name:MARTIN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:868 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-5536
Mailing Address - Country:US
Mailing Address - Phone:731-221-1637
Mailing Address - Fax:731-221-3028
Practice Address - Street 1:868 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-5536
Practice Address - Country:US
Practice Address - Phone:731-221-1637
Practice Address - Fax:731-221-3028
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant