Provider Demographics
NPI:1134363302
Name:REZEK, KRISTIN MARSH (WHNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARSH
Last Name:REZEK
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:REZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1211 27TH PL S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1806
Mailing Address - Country:US
Mailing Address - Phone:205-322-2121
Mailing Address - Fax:
Practice Address - Street 1:1211 27TH PL S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1806
Practice Address - Country:US
Practice Address - Phone:205-322-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110237363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health