Provider Demographics
NPI:1407597347
Name:HUNTLEY, KRISTIN (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:HUNTLEY
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 1:305 W CHESAPEAKE AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-9936
Mailing Address - Country:US
Mailing Address - Phone:410-853-7773
Mailing Address - Fax:
Practice Address - Street 1:305 W CHESAPEAKE AVE STE 501
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-9936
Practice Address - Country:US
Practice Address - Phone:410-853-7773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1829862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry