Provider Demographics
NPI:1588383046
Name:KOWALSKI, KRISTEN (DNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 PEERLESS XING NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3764
Mailing Address - Country:US
Mailing Address - Phone:423-476-5990
Mailing Address - Fax:423-476-5887
Practice Address - Street 1:6108 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4019
Practice Address - Country:US
Practice Address - Phone:865-539-9299
Practice Address - Fax:423-476-5887
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33661363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily