Provider Demographics
NPI:1952369308
Name:ALBRECHT, KIRSTEN ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:ELIZABETH
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:BLAKEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:4949 PROFESSIONAL PARK DR STE 202
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-8638
Practice Address - Country:US
Practice Address - Phone:704-938-9777
Practice Address - Fax:704-405-5485
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003490152W00000X
MI4901005392152W00000X
WI3572-35152W00000X
NC1849152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2120312OtherMAMSI
NC89093MHMedicaid
NC16745OtherSPECTERA
NC37-1457054OtherHCS
NC37-1457054OtherCIGNA
NC37-1457054OtherPHCS
NCNC1849OtherEYEMED/ECPA
NC804276OtherCOMMUNITY EYE CARE
NC093MHOtherBCBS
NC2200491OtherUHC
NC37-1457054OtherFHN
NC37-1457054OtherSUPERIOR
NC2120312OtherMAMSI
NCU94142Medicare UPIN
NC2200491OtherUHC