Provider Demographics
NPI:1942511696
Name:CHAFFEE, KRISTIN LEE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:LEE
Last Name:CHAFFEE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:LEE
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-955-4530
Mailing Address - Fax:501-955-4540
Practice Address - Street 1:3201 SPRINGHILL DR STE 100
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2905
Practice Address - Country:US
Practice Address - Phone:501-955-4530
Practice Address - Fax:501-955-4540
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7786207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine