Individual
KRISTEN ASHLEY HALTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2979 ALLIED ST SUITE C, GREEN BAY, WI 54304
(920) 337-6740
Mailing address
2979 ALLIED ST STE C, GREEN BAY, WI 54304-5567
(920) 337-6740
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
233644-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391498501
—
WI
Enumeration date
07/14/2017
Last updated
07/21/2022
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