Individual
KRISTIN A TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, LAT, ATC
Contact information
Practice address
5905 W NC 10 HWY, HICKORY, NC 28602-9732
(828) 485-8020
Mailing address
2176 BURKE MEADOWS RD, APT. 205, WINSTON SALEM, NC 27103-6889
(828) 485-8020
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0267
NC
363AM0700X
Medical Physician Assistant
Primary
0010-02693
NC
Other
Enumeration date
04/05/2006
Last updated
01/01/2021
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