Provider Demographics
NPI:1518459775
Name:BASKIN, KRISTEN MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MARIE
Last Name:BASKIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:185 WESLEY REED DR STE E
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-4955
Mailing Address - Country:US
Mailing Address - Phone:901-840-3937
Mailing Address - Fax:901-840-3395
Practice Address - Street 1:185 WESLEY REED DR STE E
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4955
Practice Address - Country:US
Practice Address - Phone:901-840-3937
Practice Address - Fax:901-840-3395
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3449152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist