Provider Demographics
NPI:1225336407
Name:VEREEN, KRISTEN ELION (APN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELION
Last Name:VEREEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:GEORGE ELLA
Other - Last Name:ELION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2176 BURKE MEADOWS RD APT 302
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6891
Mailing Address - Country:US
Mailing Address - Phone:901-494-2722
Mailing Address - Fax:
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:770-200-6783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007584363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health