Provider Demographics
NPI:1649348780
Name:NORTHCUTT, KRISTIN GUTH (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:GUTH
Last Name:NORTHCUTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 PINEVILLE MATTHEWS ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226
Mailing Address - Country:US
Mailing Address - Phone:704-752-8100
Mailing Address - Fax:704-752-0240
Practice Address - Street 1:7221 PINEVILLE MATTHEWS ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226
Practice Address - Country:US
Practice Address - Phone:704-752-8100
Practice Address - Fax:704-752-0240
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08576OtherBCBS
U84015Medicare UPIN
NC2449085AMedicare ID - Type Unspecified