Kristine Supple in Ventura - Physician Assistant
Kristine Supple - NPI 1720157233
Kristine Supple is a Physician Assistant in Ventura, California. Kristine Supple practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kristine Supple is 1720157233. The last update date is 2007-07-09.
Kristine Supple's current location address is 2705 Loma Vista Rd, Ventura, California. You can contact this provider via phone number 8056672801 and fax number 8056411706. The mailing address for Kristine Supple is 2705 Loma Vista Rd, Ventura, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kristine Supple |
|---|---|
| Address | 2705 Loma Vista Rd, Ventura, California |
| Phone Number | 8056672801 |
| Fax Number | 8056411706 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1720157233 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 2705 Loma Vista Rd |
|---|---|
| City | Ventura |
| State | California (CA) |
| Post Code | 930031581 |
| Phone Number | 8056672801 |
| Fax Number | 8056411706 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 15019 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| RHM08608F | CA | -- | |
| RHM18553H | CA | -- | |
| RHM08609F | CA | -- | |
| ZZT40394F | CA | -- | |
| 95-1683892 | CA | OTHER INSURANCE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kristine Supple by the Centers for Medicare & Medicaid Services?
The Kristine Supple has been issued the NPI (National Provider Identifier) 1720157233, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Kristine Supple is geographically located?
The Kristine Supple is physically situated at the following location: 2705 Loma Vista Rd, Ventura, CA, 930031581.
What is the area of specialization for Kristine Supple, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kristine Supple is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1720157233 to Kristine Supple?
The Centers for Medicare & Medicaid Services originally issued the 1720157233 to Kristine Supple on 2006-11-07.
When was the information related to Kristine Supple most recently updated or refreshed?
The details pertaining to the Kristine Supple, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-09.