Provider Demographics
NPI:1255096558
Name:DOLL, KRISTIN (AGNP-BC)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:DOLL
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5639
Mailing Address - Country:US
Mailing Address - Phone:913-265-3404
Mailing Address - Fax:
Practice Address - Street 1:11911 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5639
Practice Address - Country:US
Practice Address - Phone:913-265-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014002426363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner