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NPI Code Detail

MEDICARE: KRISTINA D. HUMPHRIES MD

MEDICARE: KRISTINA D. HUMPHRIES MD
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
1207R00000XInternal Medicine Physician32478KY
2207RE0101XEndocrinology, Diabetes & Metabolism Physician32478KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841299369
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA D. HUMPHRIES MD
Provider Business Mailing Address
First Line : PO BOX 910670
Second Line :
City : LEXINGTON
State : KY
Zip : 40591-0670
Country : US
Telephone Number : 859-219-6440
Fax Number : 859-219-6449
Provider Business Practice Location Address
First Line : 3084 LAKECREST CIR
Second Line : SUITE 100
City : LEXINGTON
State : KY
Zip : 40513-1706
Country : US
Telephone Number : 859-219-6440
Fax Number : 859-219-6449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 12/07/2020

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