Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Krystan Kimble

Individual provider Physician Assistant · NPI 1346868163

Krystan Kimble is a Physician Assistant in Boise, Idaho. Qualified in 2024, 2 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-5500
Fax: (208) 381-2555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 520 S Eagle Rd, Meridian, ID 83642-6351 — (208) 381-5500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8461874 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1346868163
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 8, 2020
Last updated in NPPESJanuary 2, 2026
Certification dateJanuary 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Boise