Healthcare Provider Details

I. General information

NPI: 1275288268
Provider Name (Legal Business Name): KRISTINA ARMISTEAD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 ASYLUM AVE
HARTFORD CT
06105-2455
US

IV. Provider business mailing address

1075 ASYLUM AVE
HARTFORD CT
06105-2455
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-4402
  • Fax: 860-714-8086
Mailing address:
  • Phone: 860-714-4402
  • Fax: 860-714-8086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5971
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: