Provider Demographics
NPI:1932185451
Name:CAIN, KRISTEN ELSA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ELSA
Last Name:CAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:ELSA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:155 QUAKER RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:631-664-4645
Mailing Address - Fax:
Practice Address - Street 1:3005 PEACHTREE RD #100 KINDBODY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:855-563-2639
Practice Address - Fax:470-468-9357
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16411207VE0102X
DCMD210011593207VE0102X
MN55231207VE0102X
KY58564207VE0102X
FLME148460207VE0102X
NY200457174400000X
WV29348207VE0102X
ND12186207VE0102X
ALMD.47729207VE0102X
NC2019-02577207VE0102X
SC91155207VE0102X
TN69044207VE0102X
GA87604207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No174400000XOther Service ProvidersSpecialist