Provider Demographics
NPI:1669024071
Name:BEVALET, KRISTEN MARIE (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:MARIE
Last Name:BEVALET
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 OPELIKA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4086
Mailing Address - Country:US
Mailing Address - Phone:334-826-1899
Mailing Address - Fax:
Practice Address - Street 1:665 OPELIKA RD STE 200
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4086
Practice Address - Country:US
Practice Address - Phone:334-826-1899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine