Provider Demographics
NPI:1780250928
Name:MUELLER, KRISTEN MICHELLE (MPH, PA-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:MUELLER
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Gender:
Credentials:MPH, PA-C
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:415 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-6004
Mailing Address - Country:US
Mailing Address - Phone:651-491-7165
Mailing Address - Fax:
Practice Address - Street 1:415 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-6004
Practice Address - Country:US
Practice Address - Phone:651-491-7165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
CA63504363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant