Provider Demographics
NPI:1790505659
Name:MICHAUD, KRISTIN (FNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 RIGSBEE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-4631
Mailing Address - Country:US
Mailing Address - Phone:910-578-2568
Mailing Address - Fax:
Practice Address - Street 1:1905 SKIBO RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0260
Practice Address - Country:US
Practice Address - Phone:910-864-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily