Provider Demographics
NPI:1548887664
Name:STRANGE, KRISTIN LESHAY (NP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:LESHAY
Last Name:STRANGE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6327
Mailing Address - Country:US
Mailing Address - Phone:423-321-4141
Mailing Address - Fax:
Practice Address - Street 1:6802 LEE HWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2444
Practice Address - Country:US
Practice Address - Phone:423-899-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN222634163W00000X
TN27786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse