Provider Demographics
NPI:1326025537
Name:FLAMM, KRISTIE L (NP)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:L
Last Name:FLAMM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N MARTIN AVE
Mailing Address - Street 2:ROOM 101 #6
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0203
Mailing Address - Country:US
Mailing Address - Phone:520-626-9937
Mailing Address - Fax:520-626-7891
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-8837
Practice Address - Fax:520-626-7891
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201404165NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2241176Medicaid
OHS84051Medicare UPIN
OHNP03465Medicare PIN
OHNP03463Medicare PIN
OH2241176Medicaid
OH9283125Medicare PIN