Provider Demographics
NPI:1982303459
Name:MAUPIN, KRISTIN PAULINE
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:PAULINE
Last Name:MAUPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-9508
Mailing Address - Country:US
Mailing Address - Phone:859-805-7009
Mailing Address - Fax:
Practice Address - Street 1:2267 STRINGTOWN RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-6900
Practice Address - Country:US
Practice Address - Phone:859-805-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide