Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN2264507 | MA |
NPI | 1033404298 |
---|---|
Provider Name | Mrs. Kristen L. Barletta |
First Address | Hanover, MA 02339-1227 |
Second Address | Hanover, MA 02339-1227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 08/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002416401 | (02) | |
110090944A | (05) | MA |