Provider Demographics
NPI:1922552942
Name:APPLE, KRISTIN
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:APPLE
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 1:325 W UPPER FERRY RD
Mailing Address - Street 2:APT B14
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2644
Mailing Address - Country:US
Mailing Address - Phone:908-599-0436
Mailing Address - Fax:
Practice Address - Street 1:66 LAWRENCEVILLE PENNINGTON RD
Practice Address - Street 2:APT B14
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08648-1666
Practice Address - Country:US
Practice Address - Phone:908-599-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00120100171100000X
PAAK001189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist