Boan, Kristy Rae

Boan, Kristy Rae is an individual health care provider with primary practice located at 155 Memorial Dr , Pinehurst NC 28374-8710. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Boan, Kristy Rae can be contacted via phone (910) 715-2164.

Contact Information

Primary practice address
155 Memorial Dr Pinehurst NC 28374-8710
Phone: (910) 715-2164
Fax: (910) 715-1926
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 0010-02678 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-02678 North Carolina

Profile Details

NPI number 1538133558
LBN Legal business name Boan, Kristy Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Mar 7th, 2012 - about 14 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 1538133558 NPPES
Nevada MEDICAID 100506041

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