Provider Demographics
NPI:1902380215
Name:AUSTIN, KRISTIN C (NMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:C
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 N SWITZER CANYON DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4834
Mailing Address - Country:US
Mailing Address - Phone:928-499-3100
Mailing Address - Fax:928-499-3100
Practice Address - Street 1:930 N SWITZER CANYON DR STE 104
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4834
Practice Address - Country:US
Practice Address - Phone:928-499-3100
Practice Address - Fax:928-499-3100
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1745175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath