Individual
KRISTEN R DORTCH-FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1469 TINY TOWN RD, CLARKSVILLE, TN 37042-7202
(931) 343-3347
(931) 905-7008
Mailing address
392 GUNSON RIDGE RD, CUMBERLAND CITY, TN 37050-4369
(931) 220-6258
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1433
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517181
—
TN
Enumeration date
12/26/2007
Last updated
08/06/2022
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