Individual
KRISTIE SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7096 DECATUR ST, NEW TRIPOLI, PA 18066-3815
(610) 298-8521
Mailing address
1605 N CEDAR CREST BLVD STE 411, ALLENTOWN, PA 18104-2323
(484) 330-1377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA060130
PA
363AM0700X
Medical Physician Assistant
Primary
MA060130
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA060130
STATE LICENSE
PA
Enumeration date
09/20/2018
Last updated
07/21/2025
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