Provider Demographics
NPI:1548710924
Name:KREPPS, KIERSTIN ALLEY (PA-C)
Entity type:Individual
Prefix:
First Name:KIERSTIN
Middle Name:ALLEY
Last Name:KREPPS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KIERSTIN
Other - Middle Name:ALLEY
Other - Last Name:KISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6885 US HIGHWAY 322
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323
Mailing Address - Country:US
Mailing Address - Phone:814-678-4810
Mailing Address - Fax:814-678-4848
Practice Address - Street 1:6885 US HIGHWAY 322
Practice Address - Street 2:SUITE 3
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1632
Practice Address - Country:US
Practice Address - Phone:814-678-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058548363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical