Individual
KRISTINA L KNISELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 RING RD, ELIZABETHTOWN, KY 42701-8968
(270) 765-2107
(270) 769-9642
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32107
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000065596
ANTHEM / NCMA
—
01
—
000023044B
HUMANA / NCMA
—
01
—
008892
SIHO / NCMA
—
01
—
1076419
PASSPORT / NCMA
—
01
—
2192467001
CIGNA / NCMA
—
01
—
2435270000
PASSPORT ADVANTAGE / NCMA
—
05
—
64321078
—
KY
Enumeration date
04/18/2006
Last updated
09/27/2022
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