Kristin M Flake, NP
Individual provider Active NPI Nurse Practitioner · South Pittsburg, TN
NPI 1851334809 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1851334809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APN0000007816 (TN)
- Practice address
- 325 S Cedar Ave Ste 2
South Pittsburg, TN 37380-1322 - Phone
- (423) 837-5801
- Fax
- (423) 837-5807
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000007816 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Path Medical Group LLC | Current | Accepting new patients | |
| Southeastern Emergency Services P C | Nurse Practitioner | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN0000007816 | TN | Yes |
Addresses
Primary practice location
325 S Cedar Ave Ste 2
South Pittsburg, TN 37380-1322
Mailing address
325S Cedar Ave 2
South Pittsburg, TN 37380-1305
Phone (423) 837-5801
Other practice location 1
1030 E 4th St
Chattanooga, TN 37403-2126
Phone (423) 837-5801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4104914 | Other | TN | BCBS OF TENNESSEE |
| P00297360 | Other | TN | RAILROAD MEDICARE |
Other providers in South Pittsburg, TN
- David Ray Clark IV
- Kassie M. Crabtree
- Crossroads Urgent Care PLLC
- Samantha Everhart Dutton
- Eyear Optical, Inc.
- Joshua Fogleman
- John Robert Fox
- Tracy G Gartman
- Thomas Charles Helm
- Katie Elizabeth Henson
All providers in South Pittsburg, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.