Provider Demographics
NPI:1912571449
Name:TZIAHANAS, KRISTIE LEE (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LEE
Last Name:TZIAHANAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 RAYMOND HIRSCH PKWY
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-8193
Mailing Address - Country:US
Mailing Address - Phone:615-672-8118
Mailing Address - Fax:615-672-4850
Practice Address - Street 1:128 RAYMOND HIRSCH PKWY
Practice Address - Street 2:ST 1
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-8193
Practice Address - Country:US
Practice Address - Phone:615-672-8118
Practice Address - Fax:615-672-4850
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4711363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant