Provider Demographics
NPI:1982831889
Name:BRITTON, KRISTINA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:BRITTON
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 1:1903 S 6TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4599
Mailing Address - Country:US
Mailing Address - Phone:218-454-3376
Mailing Address - Fax:218-454-4263
Practice Address - Street 1:415 BARCLAY AVE
Practice Address - Street 2:
Practice Address - City:PINE RIVER
Practice Address - State:MN
Practice Address - Zip Code:56474-1603
Practice Address - Country:US
Practice Address - Phone:218-454-3376
Practice Address - Fax:218-454-4263
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56276207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology