Provider Demographics
NPI:1881390177
Name:BATTS, KRISTEN LOGAN
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LOGAN
Last Name:BATTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HILLIARD ST SE APT 3
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-4009
Mailing Address - Country:US
Mailing Address - Phone:732-407-8992
Mailing Address - Fax:
Practice Address - Street 1:19 HILLIARD ST SE APT 3
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-4009
Practice Address - Country:US
Practice Address - Phone:732-407-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11292363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant