| Doctor Name: | MRS. KRISTEN PENDOLA ALLEN |
| NPI Number: | 1508209297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | NP-1261A |
| Business Practice Address: | 431 Walnut Ave N Ketchum, ID - 83340 |
| Business Phone Number: | 2086223180 |
| Business Fax Number: | |
| Mailing Address: | Po Box 999, SUN VALLEY |
| State: | ID |
| Postal Code: | 833530999 |
| Phone Number: | 2087200601 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2013 |
| NPI Last Update Date: | 04/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-1261A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |