Kristie Glen Karroum, FNP-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

PENDING Issued in ID

Practice address

3320 S 25TH E
Idaho Falls, ID 83404-4606

Phone

(208) 569-9031

NPI assigned

Dec 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kristie.karroum.1@13153.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nurture Lactation Support for Women & Infants

  • Pediatric Nurse Practitioner
  • Idaho Falls, ID
  • NPI 1740750710

  Pediatrics

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922513886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 GLENEAGLES DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016315",
            "telephone_number": "208-569-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 S 25TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044606",
            "telephone_number": "208-569-9031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5480 Gleneagles Dr",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834016315",
            "country_code": "US",
            "telephone_number": "208-569-9031",
            "fax_number": "208-569-9031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARROUM",
        "first_name": "KRISTIE",
        "middle_name": "GLEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "57631",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Stephen Kantack, PA-C
• Ramana Kanth, MD
• Thomas Allen Kantola, LPC
• James Karn
• Jennifer Sue Karns, FNP
• Jourdan Alexandria Katz, DO
• Scott Kawakami, OD
• Tauni Kaye, FNP-C
• Kayne Kishiyama MD PA
• Kboll Healthcare

• Pediatric Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Pediatric Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.