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Individual

KRISTIN KAY VANBOCKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
500 E BUSINESS WAY, SUITE A, CINCINNATI, OH 45241-2374
(513) 354-3700
(513) 354-3705
Mailing address
6480 HARRISON AVE, SUITE 201, CINCINNATI, OH 45247-7961
(513) 354-3700
(513) 354-7601

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50-003139
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000681070
ANTHEM
OH
01
567596
WELLCARE
OH
01
9234666
AETNA
OH
Enumeration date
09/17/2010
Last updated
04/26/2012
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