Individual
KRISTY RAE BOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-2164
(910) 715-1926
Mailing address
PO BOX 8500, PINEHURST, NC 28374-8500
(910) 715-1010
(910) 715-1026
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0010-02678
NC
363A00000X
Physician Assistant
0010-02678
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506041
—
NV
Enumeration date
02/15/2006
Last updated
03/07/2012
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