Provider Demographics
NPI:1750510210
Name:WAESPE, CRISTEN KELLY COMBS (MD)
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:KELLY COMBS
Last Name:WAESPE
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 1:24 CLINIC DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2166
Mailing Address - Country:US
Mailing Address - Phone:859-987-0302
Mailing Address - Fax:
Practice Address - Street 1:24 CLINIC DR
Practice Address - Street 2:SUITE A
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2166
Practice Address - Country:US
Practice Address - Phone:859-987-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45064207P00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100424330Medicaid
KY7100424330Medicaid