Individual
KRISTIE R WILBURN WREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9032
(214) 648-3280
(214) 648-7611
Mailing address
PO BOX 845347, DALLAS, TX 75390-9032
(214) 648-3280
(214) 648-7611
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
39597
TN
207V00000X
Obstetrics & Gynecology Physician
Primary
P4528
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3330159
—
TN
01
—
4105263
BLUE CROSS BLUE SHIELD OF TENNESSEE PIN
TN
Enumeration date
05/31/2005
Last updated
04/22/2016
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