Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN216454 | MA |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 048573-23 | NH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5671 | CT |
N | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | RN216454 | MA |
NPI | 1023273265 |
---|---|
Provider Name | Ms. Kristine Marie Tingley |
First Address | Boston, MA 02241-2503 |
Second Address | Dover, NH 03820-2526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2008 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3100542 | (05) | NH |