Provider Demographics
NPI:1235385097
Name:ZINKGRAF, KRISTINE M (NP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:ZINKGRAF
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:N17W24100 RIVERWOOD DR STE 250
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC.
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1177
Mailing Address - Country:US
Mailing Address - Phone:262-928-4100
Mailing Address - Fax:262-928-5835
Practice Address - Street 1:725 AMERICAN AVE FL CENTER3
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCAITES INC.
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:262-928-3500
Practice Address - Fax:262-544-0382
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2018-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI662364SA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1235385097Medicaid
68375Medicare PIN