Provider Demographics
NPI:1417257635
Name:KRISTENSEN, KARLEE J (PA)
Entity Type:Individual
Prefix:
First Name:KARLEE
Middle Name:J
Last Name:KRISTENSEN
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:701-323-5709
Practice Address - Street 1:1040 TACOMA AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-7452
Practice Address - Country:US
Practice Address - Phone:701-323-6990
Practice Address - Fax:701-323-8973
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2022-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NDPAC0917363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant