Provider Demographics
NPI:1659883080
Name:ORTS, KRISTEN MICHELE (MSN, LM, CNM, IBCLC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MICHELE
Last Name:ORTS
Suffix:
Gender:F
Credentials:MSN, LM, CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 MCCLUSKY ROAD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NY
Mailing Address - Zip Code:13084-9726
Mailing Address - Country:US
Mailing Address - Phone:315-868-1447
Mailing Address - Fax:315-800-6846
Practice Address - Street 1:4605 MCCLUSKY ROAD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NY
Practice Address - Zip Code:13084-1308
Practice Address - Country:US
Practice Address - Phone:315-868-1447
Practice Address - Fax:315-800-6846
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346312363LF0000X
NYF001827-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily