Provider Demographics
NPI:1972030393
Name:MILLS, KRISTEN CRUMBLEY (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:CRUMBLEY
Last Name:MILLS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:CRUMBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3149 DEERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-6158
Mailing Address - Country:US
Mailing Address - Phone:423-715-1504
Mailing Address - Fax:
Practice Address - Street 1:1425 S MOORE RD STE D
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2836
Practice Address - Country:US
Practice Address - Phone:423-508-8728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000022654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily