Individual
KRISTIN MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
896 WASHINGTON ST, MIDDLETOWN, CT 06457-2912
(860) 788-3632
(860) 788-2085
Mailing address
PO BOX 400, WALLINGFORD, CT 06492-7048
(203) 284-2800
(203) 294-8734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002320
CT
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008031383
—
CT
Enumeration date
08/24/2009
Last updated
07/14/2020
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