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Individual
KRISTEN KIVLEN
Active
Individual
KRISTEN KIVLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031631
VT
363A00000X
Physician Assistant
C06245
MD
363A00000X
Physician Assistant
MA058666
PA
363AS0400X
Surgical Physician Assistant
C0006245
MD
Other
Enumeration date
10/14/2016
Last updated
11/11/2022
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