Healthcare Provider Details

I. General information

NPI: 1932670163
Provider Name (Legal Business Name): KRISTINA ANDERSON DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

PO BOX 654481
DALLAS TX
75265-4481
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-3524
  • Fax:
Mailing address:
  • Phone: 610-477-6147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12774
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110006683
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: