Healthcare Provider Details

I. General information

NPI: 1053893438
Provider Name (Legal Business Name): KRISTIE ALLISON LIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 S DONAHUE DR
AUBURN AL
36849-5321
US

IV. Provider business mailing address

859 DEKALB ST
AUBURN AL
36830-8903
US

V. Phone/Fax

Practice location:
  • Phone: 408-218-3108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: