Provider Demographics
NPI:1265431225
Name:KAPLAN, KRISTEN WERT (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:WERT
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2000
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:4431 HWY 220 N
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9411
Practice Address - Country:US
Practice Address - Phone:336-643-7711
Practice Address - Fax:336-643-3047
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101206207Q00000X
FLPA3592363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00827559OtherRR MEDICARE
FLPA3592OtherMEDICAL LICENSE
NCP00827559OtherRR MEDICARE
FLS81826Medicare UPIN