Provider Demographics
NPI:1295967461
Name:BABCOCK, KIRSTEN LENORE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:LENORE
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KIRSTEN
Other - Middle Name:LENORE
Other - Last Name:HOFFMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6480 HARRISON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7785
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:500 E BUSINESS WAY
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2374
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-354-7651
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-002983363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000634209OtherANTHEM
OH9061447OtherAETNA
OH9061447OtherAETNA
OH9061447OtherAETNA