Provider Demographics
NPI:1578998522
Name:BLOCK, KRISTEN ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ASHLEY
Last Name:BLOCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BASE CAPE COD
Mailing Address - Street 2:KAEHLER MEMORIAL CLINIC
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02542
Mailing Address - Country:US
Mailing Address - Phone:508-968-6572
Mailing Address - Fax:
Practice Address - Street 1:BASE CAPE COD
Practice Address - Street 2:KAEHLER MEMORIAL CLINIC
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02542
Practice Address - Country:US
Practice Address - Phone:508-968-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant