# KRISTIN KAY POAGE

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

## Provider details

- **NPI number:** 1811329774
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 13-94813 | KS | — |
| 363L00000X | Nurse Practitioner | 53-76049-021 | KS | Yes |

## Other

- **Enumeration date:** 08/02/2013
- **Last updated:** 01/03/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 068002230 | MEDICARE PTAN | KS |
| 05 | — | 201084080A | — | KS |