Tait, Kristin M

Tait, Kristin M is an individual health care provider with primary practice located at 5050 N Clinton St , Fort Wayne IN 46825-5886. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Tait, Kristin M can be contacted via phone (260) 484-8551.

Contact Information

Primary practice address
5050 N Clinton St Fort Wayne IN 46825-5886
Phone: (260) 484-8551
Fax: (260) 482-5060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA030564 District of Columbia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002037A Indiana

Profile Details

NPI number 1447403977
LBN Legal business name Tait, Kristin M
Credentials MSHS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2008
Last updated Jan 15th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447403977 NPPES
Indiana MEDICAID 300006007

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