Provider Demographics
NPI:1972960433
Name:GUE, KRISTEN ELISE (PA-C)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ELISE
Last Name:GUE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:2500 HOSPITAL BLVD STE 490
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4975
Practice Address - Country:US
Practice Address - Phone:470-321-7500
Practice Address - Fax:678-355-4474
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2019-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA007871363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1972960433OtherNPI