Individual
CHRISTINA KVISTAD CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 NEW LONDON TPKE STE 1, NORWICH, CT 06360-2645
(860) 889-3052
Mailing address
108 NEW LONDON TPKE STE 1, NORWICH, CT 06360-2645
(860) 889-3052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4849
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508404005
NPI
—
Enumeration date
12/16/2019
Last updated
11/07/2022
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