Kautzman, Karissa Marie

Kautzman, Karissa Marie is an individual health care provider with primary practice located at 101 E Broadway Ave , Bismarck ND 58501. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Kautzman, Karissa Marie can be contacted via phone (701) 222-0386.

Contact Information

Primary practice address
101 E Broadway Ave Bismarck ND 58501
Phone: (701) 222-0386
Fax: (701) 751-5705
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1727 North Dakota
Behavioral Health & Social Service Providers / Professional 101YP2500X 1204-6-15-22A North Dakota

Profile Details

NPI number 1578975173
LBN Legal business name Kautzman, Karissa Marie
Credentials L.A.P.C.
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2014
Last updated Feb 8th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578975173 NPPES
North Dakota MEDICAID 3000

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