Healthcare Provider Details

I. General information

NPI: 1568641900
Provider Name (Legal Business Name): KRISTLE E RAILE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTLE E. NEUHALFEN PA

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 WEST FIRST
SAINT FRANCIS KS
67756-1075
US

IV. Provider business mailing address

PO BOX 1075 221 W FIRST
SAINT FRANCIS KS
67756-1075
US

V. Phone/Fax

Practice location:
  • Phone: 785-332-2682
  • Fax: 785-332-2516
Mailing address:
  • Phone: 785-332-2682
  • Fax: 785-332-2516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1501195
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: