Provider Demographics
NPI:1922823319
Name:PHIPPS, KRISTINA MARIE (CCHT, CNA)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:CCHT, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S RESERVE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-4759
Mailing Address - Country:US
Mailing Address - Phone:406-728-6585
Mailing Address - Fax:
Practice Address - Street 1:1325 S RESERVE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-4759
Practice Address - Country:US
Practice Address - Phone:406-728-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology