Provider Demographics
NPI:1881616365
Name:ATKINS, KRISTIN LEE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:LEE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1204 W MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1734
Practice Address - Country:US
Practice Address - Phone:434-924-2500
Practice Address - Fax:434-244-9487
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231858207V00000X, 207VM0101X
MDD686003207VM0101X
DCMD045622207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2003010399OtherMISSOURI STATE LICENSE#
MDD68003OtherMD STATE LICENSE #
NY241058OtherNYS LICENSE#
MD415608100Medicaid
VI0101231858OtherVIRGINA STATE LICENSE#
MD415608100Medicaid