Provider Demographics
NPI:1700107638
Name:PIERCE, KRISTEN LYNN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LYNN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:LYNN
Other - Last Name:WYGONIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3027
Mailing Address - Country:US
Mailing Address - Phone:540-316-2680
Mailing Address - Fax:540-316-2681
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3027
Practice Address - Country:US
Practice Address - Phone:540-316-2680
Practice Address - Fax:540-316-2681
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist