Provider Demographics
NPI:1831885169
Name:PAVLOVIC, KRISTINE NOELLE (FNP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:NOELLE
Last Name:PAVLOVIC
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:NOELLE
Other - Last Name:HATCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-0749
Mailing Address - Country:US
Mailing Address - Phone:802-851-8619
Mailing Address - Fax:802-851-8716
Practice Address - Street 1:272 N MAIN ST
Practice Address - Street 2:UNIT 101
Practice Address - City:CAMBRIDGE
Practice Address - State:VT
Practice Address - Zip Code:05444
Practice Address - Country:US
Practice Address - Phone:802-644-5114
Practice Address - Fax:802-888-6075
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0136022207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine