Provider Demographics
NPI:1144252933
Name:ZEHNER, KRISTINA V (PA)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:V
Last Name:ZEHNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1115
Mailing Address - Country:US
Mailing Address - Phone:240-686-2300
Mailing Address - Fax:
Practice Address - Street 1:200 MEMORIAL AVENUE
Practice Address - Street 2:CARROLL HOSPITAL CENTER
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5799
Practice Address - Country:US
Practice Address - Phone:410-871-6700
Practice Address - Fax:410-871-7177
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002765363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P43803Medicare UPIN
MD568LH271Medicare ID - Type Unspecified