Provider Demographics
NPI:1356528954
Name:THAMES, KRISTIN MARGARET
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARGARET
Last Name:THAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N. BEAVER STREET
Mailing Address - Street 2:BLDG. 2-2
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3145
Mailing Address - Country:US
Mailing Address - Phone:928-774-7997
Mailing Address - Fax:
Practice Address - Street 1:710 N. BEAVER STREET
Practice Address - Street 2:BLDG. 2-2
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3145
Practice Address - Country:US
Practice Address - Phone:928-774-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program