Individual
KRISTEN D VANWATTEGHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 MANATEE AVE W, SUITE 201, BRADENTON, FL 34205-8604
(941) 749-5222
(941) 749-1839
Mailing address
701 MANATEE AVE W, SUITE 201, BRADENTON, FL 34205-8604
(941) 749-5222
(941) 749-1839
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY0000946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4456914001
BCBS PPO
FL
01
—
S1940
BCBS
FL
Enumeration date
04/06/2007
Last updated
07/08/2007
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