Provider Demographics
NPI:1083253280
Name:DRUMEA, KIRSTEN (CMF)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:DRUMEA
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 CORDOVA GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-9198
Mailing Address - Country:US
Mailing Address - Phone:901-230-7973
Mailing Address - Fax:
Practice Address - Street 1:310 S WALNUT BEND RD STE 12
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7282
Practice Address - Country:US
Practice Address - Phone:901-417-8928
Practice Address - Fax:901-249-6594
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37713174400000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty