Provider Demographics
NPI:1265778310
Name:BATT, KRISTEN MARIE (PA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARIE
Last Name:BATT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:MARIE
Other - Last Name:DEANGELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:12240 TRAILHEAD DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-3606
Mailing Address - Country:US
Mailing Address - Phone:941-400-8131
Mailing Address - Fax:
Practice Address - Street 1:4861 27TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-1726
Practice Address - Country:US
Practice Address - Phone:941-755-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117475208000000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics