Individual
KRISTINE P KINGERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
381 S MIDDLETON RD STE B, MIDDLETON, ID 83644-5369
(208) 585-6311
Mailing address
PO BOX 277976, ATLANTA, GA 30384-7976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA582
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807305900
—
ID
Enumeration date
06/15/2006
Last updated
10/02/2024
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