Haltom, Kristen Ashley
Haltom, Kristen Ashley is an individual health care provider with primary practice located at 2979 Allied St Suite C , Green Bay WI 54304. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Haltom, Kristen Ashley can be contacted via phone (920) 337-6740.Contact Information
Primary practice address
2979 Allied St Suite C
Green Bay WI 54304
Phone: (920) 337-6740
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 233644-30 | Wisconsin |
Profile Details
| NPI number | 1689196255 |
|---|---|
| LBN Legal business name | Haltom, Kristen Ashley |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2017 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1689196255 | NPPES |
| Wisconsin | MEDICAID | 391498501 |
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