Provider Demographics
NPI:1508428723
Name:PHAIR, KRISTIN ROSE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ROSE
Last Name:PHAIR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:ROSE
Other - Last Name:STEIGAUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6602 LACASSE DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55038-7703
Mailing Address - Country:US
Mailing Address - Phone:612-306-8555
Mailing Address - Fax:
Practice Address - Street 1:6602 LACASSE DR
Practice Address - Street 2:
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55038-7703
Practice Address - Country:US
Practice Address - Phone:612-306-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily