Kristina Tanner, Physician Assistant
Physician Assistant in Birmingham, AL. Individual provider (NPI-1).
NPI number1164055018
StatusActive
Last updated in NPPESFeb 19, 2020
Details
- NPI
- 1164055018
- Entity type
- Individual (NPI-1)
- Name
- Kristina Tanner
- Credential
- Physician Assistant
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2020
- Certification date
- Feb 19, 2020
- Last updated
- Feb 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA1579 | AL | Yes |
Other names
- Kristina Tanner (Professional Name)
Practice location
52 Medical Park Dr E Ste 220Birmingham, AL 35235-3428
Phone 205-838-4747 · Fax 205-383-1251
Mailing address
52 Medical Park Dr E Ste 220Birmingham, AL 35235-3428
Phone 205-838-4747 · Fax 205-383-1251
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