Individual
KRISTINE S ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 383-3260
(217) 383-4459
Mailing address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004827
WA
Other
Enumeration date
07/19/2006
Last updated
05/08/2014
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