Provider Demographics
NPI:1417968603
Name:WALKERWICZ, KRISTEN LEIGH (DC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEIGH
Last Name:WALKERWICZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SEVEN SPRINGS WAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4575
Mailing Address - Country:US
Mailing Address - Phone:615-454-4983
Mailing Address - Fax:615-891-3074
Practice Address - Street 1:317 SEVEN SPRINGS WAY
Practice Address - Street 2:SUITE 203
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4575
Practice Address - Country:US
Practice Address - Phone:615-454-4983
Practice Address - Fax:615-891-3074
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7145077OtherAETNA
TN3145686OtherBLUE CROSS BLUE SHIELD
TN3971954Medicare ID - Type Unspecified
TN7145077OtherAETNA