Individual provider · Type 1 NPI
Kristen Johanna Mary Wils, MD
Student in an Organized Health Care Education/Training Program · Portland, CT
NPI number
1023802022
Active
Practice location
13 High St
Portland, CT 06480-1616
Mailing address
28 Crescent St
Middletown, CT 06457-3654
Other practice locations
- 42 E High St Ste 205, East Hampton, CT 06424-1056 · (860) 358-6418
- 90 S Main St, Middletown, CT 06457-3649 · (860) 358-6418
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2 other providers at this address
Other student in an organized health care education/training program providers in Portland
About NPI 1023802022
Kristen Johanna Mary Wils, MD's National Provider Identifier is 1023802022, issued on Apr 7, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, CT. The record was last updated on May 28, 2025.