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NPI Code Detail

MEDICARE: KRISTEN MICHELLE MUNDY PA-C

MEDICARE: KRISTEN MICHELLE MUNDY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant001006767NC
2363A00000XPhysician Assistant0010-06767NC

General Provider Information

NPI Number : 1275083974
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN MICHELLE MUNDY PA-C
Provider Business Mailing Address
First Line : 2000 PERIMETER PARK DR STE 200
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-8442
Country : US
Telephone Number : 984-215-4111
Fax Number :
Provider Business Practice Location Address
First Line : 1120 SE CARY PKWY
Second Line : SUITE 100
City : CARY
State : NC
Zip : 27518-7413
Country : US
Telephone Number : 919-467-4992
Fax Number : 919-481-9607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2016
Last Update Date : 02/13/2026

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Directions to “ KRISTEN MICHELLE MUNDY PA-C” Practice Location

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