MEDICARE: MRS. KRISTIN KAY BABB PA

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	3518	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1598843831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN KAY BABB PA

Provider Business Mailing Address
First Line	:	10238 E HAMPTON AVE
Second Line	:	SUITE 501
City	:	MESA
State	:	AZ
Zip	:	85209
Country	:	US
Telephone Number	:	480-889-1573
Fax Number	:	480-889-1574

Provider Business Practice Location Address
First Line	:	10238 E HAMPTON AVE
Second Line	:	SUITE 501
City	:	MESA
State	:	AZ
Zip	:	85209
Country	:	US
Telephone Number	:	480-889-1573
Fax Number	:	480-889-1574

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	05/05/2014

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