Individual
KRISTA ROXANN NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
353 BLAIR PARK RD, WOMEN'S HEALTH SERVICE, WILLISTON, VT 05495-7530
(802) 847-1600
Mailing address
79 FRONT ST, BURLINGTON, VT 05401-4302
(802) 881-8804
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
101-0025978
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012201
—
VT
Enumeration date
08/01/2006
Last updated
07/08/2007
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