Provider Demographics
NPI:1063856078
Name:KIHLE, KRISTIN MARIE (CTRS, R/TRO, CTRAC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:MARIE
Last Name:KIHLE
Suffix:
Gender:F
Credentials:CTRS, R/TRO, CTRAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 HURON SHORES DRIVE
Mailing Address - Street 2:
Mailing Address - City:SARNIA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N7T7H4
Mailing Address - Country:CA
Mailing Address - Phone:519-491-6161
Mailing Address - Fax:
Practice Address - Street 1:2155 HURON SHORES DRIVE
Practice Address - Street 2:
Practice Address - City:SARNIA
Practice Address - State:ONTARIO
Practice Address - Zip Code:N7T7H4
Practice Address - Country:CA
Practice Address - Phone:519-491-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY56893172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker