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General NPI Number Information
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NPI Number | 1144565342
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Entity Type | Individual
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Provider Name | KRISTEN VERCHICK
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Gender | Female
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Dates
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Enumeration Date | 11/29/2012
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 2432 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505-3392
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Country | US
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Telephone | 505-424-1066
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Fax | 505-424-4263
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Provider Business Mailing Address
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Address Line | 8800 SE SUNNYSIDE RD STE 300N
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City | CLACKAMAS
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State | OR
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Zip | 97015-5703
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Country | US
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Telephone | 612-351-1529
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Fax | 952-915-6290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 0801
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License Number State | NM
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