Provider Demographics
NPI:1730526179
Name:WILLER, KRISTIN MARIE (DVM)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MARIE
Last Name:WILLER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 2ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:PIERZ
Mailing Address - State:MN
Mailing Address - Zip Code:56364-1519
Mailing Address - Country:US
Mailing Address - Phone:320-468-6174
Mailing Address - Fax:
Practice Address - Street 1:105 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:PIERZ
Practice Address - State:MN
Practice Address - Zip Code:56364-1519
Practice Address - Country:US
Practice Address - Phone:320-468-6174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN05013174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian