MEDICARE: MRS. KRISTEN ANN LUND 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
1	363AM0700X	Medical Physician Assistant	PA15606	TX

General Provider Information

NPI Number	:	1326659848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTEN ANN LUND PA-C

Provider Business Mailing Address
First Line	:	5725 W ARBOR HILLS WAY APT 114
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-5366
Country	:	US
Telephone Number	:	214-354-6670
Fax Number	:

Provider Business Practice Location Address
First Line	:	997 RAINTREE CIR STE 130
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-4953
Country	:	US
Telephone Number	:	972-449-7940
Fax Number	:	972-390-1557

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	05/02/2022

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