Provider Demographics
NPI:1528021268
Name:BARR, KRISTI L (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:BARR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 PINE HALL ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-237-0001
Mailing Address - Fax:814-237-0116
Practice Address - Street 1:1951 PINE HALL ROAD
Practice Address - Street 2:SUITE 225
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801
Practice Address - Country:US
Practice Address - Phone:814-237-0001
Practice Address - Fax:814-237-0116
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051031363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP66897Medicare UPIN