Outwater, Kristan M

Outwater, Kristan M is an sole proprietor health care provider with primary practice located at 21 Belmont Ave , Brattleboro VT 05301-7110. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Outwater, Kristan M can be contacted via phone (802) 258-3905.

Contact Information

Primary practice address
21 Belmont Ave Brattleboro VT 05301-7110
Phone: (802) 258-3905
Fax: (802) 258-4903
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 4301064412 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 042-0012623 Vermont

Profile Details

NPI number 1306952890
LBN Legal business name Outwater, Kristan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 21st, 2006
Last updated Jun 30th, 2023 - about last year

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 1306952890 NPPES
Michigan Other 71020000730099 BCBS OF MI
Michigan MEDICAID 3067291 BCBS OF MI

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