| Doctor Name: | KRISTA JOY HAITH |
| NPI Number: | 1083864292 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 1668 |
| Business Practice Address: | 650 Joel Dr Credentials Office Fort Campbell, KY - 422235318 |
| Business Phone Number: | 2707988372 |
| Business Fax Number: | 2709560180 |
| Mailing Address: | 650 Joel Drive, Credentials Office FORT CAMPBELL |
| State: | KY |
| Postal Code: | 42223 |
| Phone Number: | 2707988372 |
| Fax Number: | 2709560180 |
| NPI Enumeration Date: | 09/24/2008 |
| NPI Last Update Date: | 09/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1668 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |