Basic Information
| Provider Information | |||||||||
| NPI: | 1952369308 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALBRECHT | ||||||||
| FirstName: | KIRSTEN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1950 OLD GALLOWS RD | ||||||||
| Address2: | SUITE 520 | ||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221823990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038478899 | ||||||||
| FaxNumber: | 7039910514 | ||||||||
| Practice Location | |||||||||
| Address1: | 584 CHURCH ST N | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280254573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047820677 | ||||||||
| FaxNumber: | 7042629772 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1849 | NC | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 2120312 | 01 | NC | MAMSI | OTHER | 37-1457054 | 01 | NC | HCS | OTHER | 37-1457054 | 01 | NC | SUPERIOR | OTHER | NC1849 | 01 | NC | EYEMED/ECPA | OTHER | 2200491 | 01 | NC | UHC | OTHER | 37-1457054 | 01 | NC | CIGNA | OTHER | 37-1457054 | 01 | NC | FHN | OTHER | 37-1457054 | 01 | NC | PHCS | OTHER | 804276 | 01 | NC | COMMUNITY EYE CARE | OTHER | 16745 | 01 | NC | SPECTERA | OTHER | 093MH | 01 | NC | BCBS | OTHER | 89093MH | 05 | NC | MEDICAID |