Provider Demographics
NPI:1700650587
Name:PARSONS, KRISTEN MARIE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:PARSONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 BOSTON POST RD # 1068
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2755
Mailing Address - Country:US
Mailing Address - Phone:203-273-7172
Mailing Address - Fax:
Practice Address - Street 1:70 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477
Practice Address - Country:US
Practice Address - Phone:203-273-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1881133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist