Provider Demographics
NPI:1548228018
Name:ABBRUZZI, KRISTIN L (PA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:L
Last Name:ABBRUZZI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 GETTYSBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2520
Mailing Address - Country:US
Mailing Address - Phone:317-607-3091
Mailing Address - Fax:614-442-7726
Practice Address - Street 1:4900 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2520
Practice Address - Country:US
Practice Address - Phone:317-607-3091
Practice Address - Fax:614-442-7726
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000801P363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant