MS. Kristy Michelle Fogle, PA-C

NPI #1508291410 in Randallstown, Maryland

Provider Information

NPI Number: 1508291410
Entity Type: Individual
Name: MS. Kristy Michelle Fogle, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 10, 2013
Last Updated: Sep 10, 2013

Practice Location

Address: 5401 OLD COURT ROAD
Address 2: NORTHWEST HOSPITAL-EMERGENCY DEPARTMENT
City: Randallstown
State: Maryland
ZIP Code: 21133
Phone: (443) 848-8705

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Physician Assistant - Medical — Medical	363AM0700X

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