Provider Demographics
NPI:1205677853
Name:REEL, KRISTIN KINGERY (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KINGERY
Last Name:REEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:KINGERY
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4327 BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2303
Mailing Address - Country:US
Mailing Address - Phone:940-764-5200
Mailing Address - Fax:
Practice Address - Street 1:1523 FAIR RD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6025
Practice Address - Country:US
Practice Address - Phone:912-871-2000
Practice Address - Fax:912-871-2500
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant