Provider Demographics
NPI:1467773895
Name:LUMM, KRISTIN M (DPT, CLT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:LUMM
Suffix:
Gender:F
Credentials:DPT, CLT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:M
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:18501 MAUGANS AVE STE 101
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3393
Practice Address - Country:US
Practice Address - Phone:301-733-1700
Practice Address - Fax:301-733-1711
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS999/184842ZFP1Medicare PIN