Individual
KRISTIN A CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
381 S MIDDLETON RD STE B, SUITE 115, MIDDLETON, ID 83644-5369
(208) 585-6311
(208) 585-6221
Mailing address
381 S MIDDLETON RD STE B, SUITE 115, MIDDLETON, ID 83644-5369
(208) 585-6311
(208) 585-6221
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA239
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017487
BLUE SHIELD
ID
01
—
000010017488
BLUE SHIELD
ID
05
—
805233800
—
ID
01
—
970019572
RAILROAD MEDICARE
ID
01
—
PA811
BLUE CROSS
ID
01
—
PA860
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
01/15/2015
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