Provider Demographics
NPI:1194043364
Name:CHRISTIAN, KRISTINA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:NICOLE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-9571
Mailing Address - Fax:
Practice Address - Street 1:1629 ASHLAND RD
Practice Address - Street 2:
Practice Address - City:GREENUP
Practice Address - State:KY
Practice Address - Zip Code:41144-1249
Practice Address - Country:US
Practice Address - Phone:606-473-0687
Practice Address - Fax:606-473-0689
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine