| Doctor Name: | KRISTINE S ANDERSON |
| NPI Number: | 1023037173 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PA10004827 |
| Business Practice Address: | 1802 S Mattis Ave Champaign, IL - 618215923 |
| Business Phone Number: | 2173833260 |
| Business Fax Number: | 2173834459 |
| Mailing Address: | 611 W. Park St., URBANA |
| State: | IL |
| Postal Code: | 618012500 |
| Phone Number: | 2173836941 |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 05/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA10004827 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |