Provider Demographics
NPI:1831670629
Name:SANTANA, KRISTEN ELIZABETH (AGNP-C, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:SANTANA
Suffix:
Gender:F
Credentials:AGNP-C, WHNP-BC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:E
Other - Last Name:KOLNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGNP-PC,WHNP-BC
Mailing Address - Street 1:333 N 1ST ST STE 240
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6132
Mailing Address - Country:US
Mailing Address - Phone:208-338-8900
Mailing Address - Fax:208-947-1190
Practice Address - Street 1:333 N 1ST ST STE 240
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6132
Practice Address - Country:US
Practice Address - Phone:208-338-8900
Practice Address - Fax:208-947-1190
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID57865363LG0600X, 363LW0102X, 367A00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife