Bencik Boudreau, Kristin D
Bencik Boudreau, Kristin D is an individual health care provider with primary practice located at 7950 N Port Washington Rd , Fox Point WI 53217-3131. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bencik Boudreau, Kristin D can be contacted via phone (414) 228-0099.Contact Information
Primary practice address
7950 N Port Washington Rd
Fox Point WI 53217-3131
Phone: (414) 228-0099
Fax: (414) 540-0165
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 43405 | Wisconsin |
Profile Details
| NPI number | 1588660195 |
|---|---|
| LBN Legal business name | Bencik Boudreau, Kristin D |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2005 |
| Last updated | Sep 16th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588660195 | NPPES |
| Wisconsin | MEDICAID | 32858800 |
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