Provider Demographics
NPI:1760670764
Name:VOGEL, KRISTIN K (PA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N NORTON AVE
Mailing Address - Street 2:PO BOX 250
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-1449
Mailing Address - Country:US
Mailing Address - Phone:785-877-3305
Mailing Address - Fax:785-877-3646
Practice Address - Street 1:711 N NORTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-1449
Practice Address - Country:US
Practice Address - Phone:785-877-3305
Practice Address - Fax:785-877-3646
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-01599363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant