Provider Demographics
NPI:1306848841
Name:ADAIR, KIRSTEN M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:M
Last Name:ADAIR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4071 TATES CREEK CENTRE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3094
Mailing Address - Country:US
Mailing Address - Phone:859-226-0206
Mailing Address - Fax:
Practice Address - Street 1:4071 TATES CREEK CENTRE DR STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-3094
Practice Address - Country:US
Practice Address - Phone:859-226-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA517363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65926933Medicaid
KY65926933Medicaid
S96803Medicare UPIN
KYK034600Medicare PIN