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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65926933
—
KY
Enumeration date
08/15/2005
Last updated
03/20/2026
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