Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Kristina Lucille Polley, PA-C

Individual provider Physician Assistant · NPI 1700274313

Mrs. Kristina Lucille Polley, PA-C is a Physician Assistant in Fayetteville, North Carolina. Qualified in 2014, 12 years ago. Practices with Lifesource of North Carolina, a 170-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
12
Licensed in
NC
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2409 Murchison Rd
Fayetteville, NC 28301-3519
Phone: (910) 488-4525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 — (910) 742-9243

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-05418 (NC)

Record details

NPI number1700274313
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2015
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fayetteville