Provider Demographics
NPI:1568451144
Name:STRANGE, KRISTIN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:K
Last Name:STRANGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7154 THREE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-3194
Mailing Address - Country:US
Mailing Address - Phone:704-576-2231
Mailing Address - Fax:
Practice Address - Street 1:3800 MEETING ST STE 222
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:NC
Practice Address - Zip Code:28079-6582
Practice Address - Country:US
Practice Address - Phone:704-576-2231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501668208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910386Medicaid
NC8910386Medicaid
NC8910386Medicaid