Provider Demographics
NPI:1699055749
Name:ATTIOGBE, KRISTIN MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:ATTIOGBE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 PROSPERITY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1640
Mailing Address - Country:US
Mailing Address - Phone:240-485-5210
Mailing Address - Fax:
Practice Address - Street 1:5550 FRIENDSHIP BLVD STE T90
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7313
Practice Address - Country:US
Practice Address - Phone:240-737-0085
Practice Address - Fax:202-296-0301
Is Sole Proprietor?:No
Enumeration Date:2011-08-21
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1003643363LF0000X
MDR233846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily