Provider Demographics
NPI:1679516439
Name:JAMES, KRISTINE T (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:T
Last Name:JAMES
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:TURNER
Other - Last Name:GARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:17904 GEORGIA AVENUE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-232-1050
Mailing Address - Fax:301-232-1044
Practice Address - Street 1:17904 GEORGIA AVENUE
Practice Address - Street 2:SUITE 215
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-232-1050
Practice Address - Fax:301-232-1044
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001183363A00000X, 363AS0400X
DCPA30055363AS0400X
1016117363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant