Provider Demographics
NPI:1568641900
Name:RAILE, KRISTLE E (PA)
Entity type:Individual
Prefix:MRS
First Name:KRISTLE
Middle Name:E
Last Name:RAILE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:KRISTLE
Other - Middle Name:E
Other - Last Name:NEUHALFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 1075
Mailing Address - Street 2:221 W FIRST
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-1075
Mailing Address - Country:US
Mailing Address - Phone:785-332-2682
Mailing Address - Fax:785-332-2516
Practice Address - Street 1:221 WEST FIRST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-1075
Practice Address - Country:US
Practice Address - Phone:785-332-2682
Practice Address - Fax:785-332-2516
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS427229OtherBCBS
KS200532090AMedicaid
KS200532090AMedicaid