Kristen Ashley Haltom, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

233644-30 Issued in WI

Practice address

2979 Allied St Suite C
Green Bay, WI 54304

Phone

(920) 337-6740

NPI assigned

Jul 14, 2017

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

• Kristen Ashley Vanhandel Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689196255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 ALLIED ST STE C",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045567",
            "telephone_number": "920-337-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 ALLIED ST SUITE C",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-337-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTOM",
        "first_name": "KRISTEN",
        "middle_name": "ASHLEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "233644-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391498501",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "VANHANDEL",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert W Haller, MD
• Brooke Hallet, SACIT
• Thomas Joseph Halloin, MD
• Eric J Hallquist, MD
• Steven Alan Halsey, MD
• Heather Ann Halverson, APNP
• Nicole M Halverson
• Melissa Marie Hamachek, PMHNP
• Daniel J Hamersky
• Todd Lee Hamilton, PSY.D.

• All providers in Green Bay, WI
• Addiction (Substance Use Disorder) Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.