Provider Demographics
NPI:1295440998
Name:DOHM, KRISTEN CLAIRE (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:CLAIRE
Last Name:DOHM
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 1:609 SHADOW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7527
Mailing Address - Country:US
Mailing Address - Phone:520-289-6780
Mailing Address - Fax:
Practice Address - Street 1:609 SHADOW GLEN DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-7527
Practice Address - Country:US
Practice Address - Phone:520-289-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant