Individual
KRISTIN BOST GAFFNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MSPAS
Contact information
Practice address
3707 LARGENT WAY NW, MARIETTA, GA 30064
(678) 581-5729
(678) 581-5719
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-04394
NC
363AM0700X
Medical Physician Assistant
1715
SC
363AM0700X
Medical Physician Assistant
Primary
7932
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457633307
—
NC
05
—
1742PA
—
SC
Enumeration date
09/16/2011
Last updated
11/06/2019
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