Individual
KRIS H STIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1824 KING ST, STE 200, JACKSONVILLE, FL 32204-4735
(904) 384-3343
(904) 400-6671
Mailing address
1824 KING ST, STE 200, JACKSONVILLE, FL 32204-4735
(904) 384-3343
(904) 400-6671
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2738
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290099800
—
FL
01
—
970020282
MEDICARE RAILROAD
—
Enumeration date
06/09/2005
Last updated
03/31/2025
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