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General NPI Number Information
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NPI Number | 1841596681
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Entity Type | Individual
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Provider Name | KRISTIN MARIE ROELFS MPAS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 210 MCNEEL LN
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6290
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Country | US
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Telephone | 308-534-9230
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Fax | 308-534-5016
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Provider Business Mailing Address
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Address Line | 501 N ALLEN AVE
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City | NORTH PLATTE
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State | NE
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Zip | 69101-1411
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Country | US
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Telephone | 402-305-6478
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1564
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License Number State | NE
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