Provider Demographics
NPI:1235649989
Name:ROGERS, KRISTY KAY MARTIN (MS, PA-C)
Entity Type:Individual
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First Name:KRISTY
Middle Name:KAY MARTIN
Last Name:ROGERS
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Gender:F
Credentials:MS, PA-C
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Mailing Address - Street 1:3890 YOUNG RD
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-8152
Mailing Address - Country:US
Mailing Address - Phone:336-596-7812
Mailing Address - Fax:
Practice Address - Street 1:4515 PREMIER DR STE 201
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8356
Practice Address - Country:US
Practice Address - Phone:336-802-2610
Practice Address - Fax:336-802-2611
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-07643363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant