Provider Demographics
NPI:1609691302
Name:MILLER, KRISTEN LUCILLE (NBC-HWC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LUCILLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SNOWBIRD LN
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149-9400
Mailing Address - Country:US
Mailing Address - Phone:802-417-7222
Mailing Address - Fax:
Practice Address - Street 1:72 SNOWBIRD LN
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-9400
Practice Address - Country:US
Practice Address - Phone:802-417-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTA-3662305171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach