Provider Demographics
NPI:1588857395
Name:SPRATT, KRISTEN JEAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JEAN
Last Name:SPRATT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 WEDDINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:WEDDINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:704-847-4000
Mailing Address - Fax:704-847-4001
Practice Address - Street 1:1932 WEDDINGTON RD
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104-8318
Practice Address - Country:US
Practice Address - Phone:704-847-4000
Practice Address - Fax:704-847-4001
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ59848Medicare UPIN