Supple, Kristine

Supple, Kristine is an individual health care provider with primary practice located at 2921 Saviers Rd , Oxnard CA 93033-5314. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Supple, Kristine can be contacted via phone (805) 487-5588.

Contact Information

Primary practice address
2921 Saviers Rd Oxnard CA 93033-5314
Phone: (805) 487-5588
Fax: (805) 487-5589
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 15019 California

Profile Details

NPI number 1720157233
LBN Legal business name Supple, Kristine
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720157233 NPPES
California MEDICAID RHM08608F
California MEDICAID RHM18553H
California MEDICAID RHM08609F
California MEDICAID ZZT40394F
California Other 95-1683892

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