Provider Demographics
NPI:1992185557
Name:MYERS, KRISTI LEIGH (FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTI
Middle Name:LEIGH
Last Name:MYERS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 44
Mailing Address - Street 2:
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-8012
Mailing Address - Country:US
Mailing Address - Phone:423-441-8011
Mailing Address - Fax:423-441-8014
Practice Address - Street 1:6650 CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:HARROGATE
Practice Address - State:TN
Practice Address - Zip Code:37752-8012
Practice Address - Country:US
Practice Address - Phone:423-441-8011
Practice Address - Fax:423-441-8014
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily