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Individual

KRISTINA TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
52 MEDICAL PARK DR E STE 220, BIRMINGHAM, AL 35235-3428
(205) 838-4747
(205) 383-1251
Mailing address
52 MEDICAL PARK DR E STE 220, BIRMINGHAM, AL 35235-3428
(205) 838-4747
(205) 383-1251

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1579
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA1579
ALABAMA LICENSE
AL
Enumeration date
02/19/2020
Last updated
02/19/2020
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