Provider Demographics
NPI:1922522796
Name:THORPE, KRISTIN RENEE
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RENEE
Last Name:THORPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 N SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2344
Mailing Address - Country:US
Mailing Address - Phone:248-678-7773
Mailing Address - Fax:
Practice Address - Street 1:689 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2344
Practice Address - Country:US
Practice Address - Phone:248-456-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator