Provider Demographics
NPI:1770870107
Name:NORQUEST, KRISTIN L (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:NORQUEST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:L
Other - Last Name:FAULHABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:137 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2284
Mailing Address - Country:US
Mailing Address - Phone:302-233-1128
Mailing Address - Fax:
Practice Address - Street 1:101 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4366
Practice Address - Country:US
Practice Address - Phone:302-651-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant