Provider Demographics
NPI:1821416694
Name:BEAVER, KRISTEN BANKS (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:BANKS
Last Name:BEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 205W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1117 HAVASU FALLS CIR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-8559
Practice Address - Country:US
Practice Address - Phone:512-797-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01027207L00000X
NC390200000X
MT80025207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program