Provider Demographics
NPI:1164733671
Name:STRANNIGAN, KRISTIN LYNN (DPM)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNN
Last Name:STRANNIGAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CELESTE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2832
Mailing Address - Country:US
Mailing Address - Phone:814-255-6781
Mailing Address - Fax:814-255-5716
Practice Address - Street 1:2 CELESTE DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-2832
Practice Address - Country:US
Practice Address - Phone:814-255-6781
Practice Address - Fax:814-255-5716
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3647213E00000X, 213ES0103X
PASC006226213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000559282OtherHIGHMARK BLUE SHIELD
GA003154187AMedicaid
FL013678100Medicaid