# KRISTIN KAY VANBOCKEL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1750699245
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 50-003139 | OH | Yes |

## Other

- **Enumeration date:** 09/17/2010
- **Last updated:** 04/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000681070 | ANTHEM | OH |
| 01 | — | 567596 | WELLCARE | OH |
| 01 | — | 9234666 | AETNA | OH |