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Individual

MRS. KRISTEN AMANDA ETTLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
HARRY S. TRUMAN MEMORIAL VETERANS HOSPITAL, 800 HOSPITAL DRIVE, COLUMBIA, MO 65201
(573) 814-6565
(573) 814-6176
Mailing address
4140 HIGHWAY 54, FULTON, MO 65251-3848
(573) 544-7907

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021001164
MO

Other

Enumeration date
02/29/2020
Last updated
09/18/2023
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