Provider Demographics
NPI:1225227721
Name:TELFOR, KRISTEN MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARIE
Last Name:TELFOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4595 JENNIFER LANE
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1083
Mailing Address - Country:US
Mailing Address - Phone:989-772-0453
Mailing Address - Fax:989-773-2538
Practice Address - Street 1:4595 JENNIFER LANE
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1083
Practice Address - Country:US
Practice Address - Phone:989-772-0453
Practice Address - Fax:989-773-2538
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704261092363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5008773170OtherBCBSM
MIN55280008Medicare PIN
MI5008773170OtherBCBSM