Individual
DR. KRISTEN JOHANNA MARY WILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13 HIGH ST, PORTLAND, CT 06480-1616
(860) 358-6418
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6418
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2025
Last updated
05/28/2025
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