Provider Demographics
NPI:1699951145
Name:PUTMAN, KRISTINE LYNEA (CRNP)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:LYNEA
Last Name:PUTMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5310
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5541
Mailing Address - Country:US
Mailing Address - Phone:256-355-9711
Mailing Address - Fax:256-351-9717
Practice Address - Street 1:1874 BELTLINE RD, SW
Practice Address - Street 2:SUITE 105
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5541
Practice Address - Country:US
Practice Address - Phone:256-355-9711
Practice Address - Fax:256-351-9717
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-091197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily