Provider Demographics
NPI:1164459491
Name:ISENMAN, KRISTINE KAY (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:KAY
Last Name:ISENMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 STOCKDALE HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3653
Mailing Address - Country:US
Mailing Address - Phone:661-665-7880
Mailing Address - Fax:661-665-7881
Practice Address - Street 1:9802 STOCKDALE HWY STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3653
Practice Address - Country:US
Practice Address - Phone:661-665-7880
Practice Address - Fax:661-665-7881
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14378363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAP14378BMedicare ID - Type UnspecifiedPPIN
CAWPA14378CMedicare ID - Type UnspecifiedPPIN
CAWPA14378AMedicare ID - Type UnspecifiedPPIN