Healthcare Provider Details

I. General information

NPI: 1760670764
Provider Name (Legal Business Name): KRISTIN K. VOGEL P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N NORTON AVE
NORTON KS
67654-1449
US

IV. Provider business mailing address

711 N NORTON AVE PO BOX 250
NORTON KS
67654-1449
US

V. Phone/Fax

Practice location:
  • Phone: 785-877-3305
  • Fax: 785-877-3646
Mailing address:
  • Phone: 785-877-3305
  • Fax: 785-877-3646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberT-01599
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: