Individual
MRS. KRISTA J TREVATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3310 RUCKRIEGEL PKWY, JEFFERSONTOWN, KY 40299-3764
(502) 212-0071
(502) 996-8359
Mailing address
110 CHASE WAY STE 2, ELIZABETHTOWN, KY 42701-7827
(502) 212-0071
(502) 996-8359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA238
KY
363AM0700X
Medical Physician Assistant
PA238
KY
363AS0400X
Surgical Physician Assistant
PA238
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65926933
—
KY
Enumeration date
08/15/2005
Last updated
07/31/2026
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