Individual
KRISTEN HALVORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
517 ROUTE 72 W STE J, MANAHAWKIN, NJ 08050-2821
(800) 321-9999
(267) 479-1321
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(267) 339-7843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00674500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1181082
NCCPA CERTIFICATION NUMBER
—
Enumeration date
01/19/2017
Last updated
11/10/2022
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