Provider Demographics
NPI:1114440740
Name:TEKIN, KRISTEN CLARK (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:CLARK
Last Name:TEKIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6409 ABERCORN ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5796
Mailing Address - Country:US
Mailing Address - Phone:859-327-1190
Mailing Address - Fax:
Practice Address - Street 1:3400 OLD MILTON PKWY STE C270
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4414
Practice Address - Country:US
Practice Address - Phone:770-442-1911
Practice Address - Fax:770-663-8905
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant