Individual
KRISTEN KATHARINA ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
555 WASHINGTON HWY, MORRISVILLE, VT 05661
(802) 760-6291
Mailing address
555 WASHINGTON HWY, MORRISVILLE, VT 05661-8972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
055.0031410
VT
363AM0700X
Medical Physician Assistant
Primary
055.0031410
VT
Other
Enumeration date
12/10/2018
Last updated
12/07/2021
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