Provider Demographics
NPI:1316288111
Name:COLES, KRISTEN ANNA (ND, LAC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANNA
Last Name:COLES
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANNA
Other - Last Name:SPITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND, LAC
Mailing Address - Street 1:222 TUCKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-9585
Mailing Address - Country:US
Mailing Address - Phone:425-761-9781
Mailing Address - Fax:800-382-4146
Practice Address - Street 1:222 TUCKER HILL RD
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9585
Practice Address - Country:US
Practice Address - Phone:802-230-7962
Practice Address - Fax:800-382-4146
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND 234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine