Provider Demographics
NPI:1457327884
Name:INNES, KRISTEN NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:NELSON
Last Name:INNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:CORRINE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3880 PARKWOOD BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1928
Mailing Address - Country:US
Mailing Address - Phone:214-618-2802
Mailing Address - Fax:214-618-3208
Practice Address - Street 1:3880 PARKWOOD BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1928
Practice Address - Country:US
Practice Address - Phone:214-618-2802
Practice Address - Fax:214-618-3208
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37390207V00000X
TXM2658207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology