Provider Demographics
NPI:1609163534
Name:FARTHING, KRISTEN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:FARTHING
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:116 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1307
Mailing Address - Country:US
Mailing Address - Phone:317-773-7400
Mailing Address - Fax:317-773-9029
Practice Address - Street 1:116 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1307
Practice Address - Country:US
Practice Address - Phone:317-956-6284
Practice Address - Fax:317-956-6289
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99047591A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10004192OtherINDY LIC
INM400051819Medicare PIN