Provider Demographics
NPI:1629211602
Name:KREIDER, KRISTIN DIANA (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DIANA
Last Name:KREIDER
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 1:880 KEMPSVILLE RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3990
Mailing Address - Country:US
Mailing Address - Phone:757-466-6350
Mailing Address - Fax:
Practice Address - Street 1:880 KEMPSVILLE RD STE 2200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3990
Practice Address - Country:US
Practice Address - Phone:757-466-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249522207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology