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General NPI Number Information
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NPI Number | 1417261934
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Entity Type | Individual
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Provider Name | KYRSTEN E STOOPS MD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 623 S MAIN ST STE 1
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City | MOSCOW
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State | ID
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Zip | 83843
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Country | US
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Telephone | 208-882-2011
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Fax | 208-883-1853
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Provider Business Mailing Address
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Address Line | PO BOX 8007
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City | MOSCOW
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State | ID
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Zip | 83843-0507
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Country | US
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Telephone | 208-883-2224
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Fax | 208-883-6580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-12207
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.60298970
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License Number State | WA
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