Individual
KRISTEN R STAKELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1138 LEXINGTON RD, STE 290, GEORGETOWN, KY 40324-9672
(502) 863-0721
(502) 863-6104
Mailing address
1138 LEXINGTON RD, STE 290, GEORGETOWN, KY 40324-9672
(502) 863-0721
(502) 863-6104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34091
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64017395
—
KY
Enumeration date
07/20/2005
Last updated
07/08/2007
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