Individual
DR. KRISTIE MICHELLE JETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 272-2244
(813) 272-3766
Mailing address
12901 BRUCE B DOWNS BLVD, MDC 41, TAMPA, FL 33612-4742
(813) 844-7412
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME130758
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2013
Last updated
12/31/2024
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