Provider Demographics
NPI:1013351717
Name:ORCUTT, KRISTINE LOUISE (RCR)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LOUISE
Last Name:ORCUTT
Suffix:
Gender:F
Credentials:RCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1825
Mailing Address - Country:US
Mailing Address - Phone:515-778-9342
Mailing Address - Fax:
Practice Address - Street 1:6435 COLBY AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1825
Practice Address - Country:US
Practice Address - Phone:515-778-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA39173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist