Most Relevant Information
Provider Data
| NPI Number: | 1003078148 |
| Provider Name: | KRISTINE K VAN KIRK M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207QA0505X |
| Specialty: | Family Medicine |
| License Number: | 9074A |
Most Important Dates
| Enumeration Date: | 06/30/2008 |
| Last Updated: | 01/03/2019 |
Provider Practice Location
6015 SYCAMORE RD
CHEYENNE
WY
820094347
Practice Location Phone/Fax
| Phone: | 3078232968 |
| Fax: |
Provider Mailing Location
6015 SYCAMORE RD
CHEYENNE
WY
820094347
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |