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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588660195 NPPES
Wisconsin MEDICAID 32858800

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