Individual
KRISTIN LYNN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
210 4TH AVE, GRINNELL, IA 50112-1898
(641) 236-2055
(641) 236-2907
Mailing address
210 4TH AVE, GRINNELL, IA 50112-1898
(641) 236-2055
(641) 236-2907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001915
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73096
WELLMARK BCBS
IA
Enumeration date
07/08/2008
Last updated
07/29/2009
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