Provider Demographics
NPI:1033498886
Name:CARLISLE, CRISTINA QUINTI (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:QUINTI
Last Name:CARLISLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:CRISTINA
Other - Middle Name:QUINTI
Other - Last Name:AGOSTINELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3 FARM GLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1981
Mailing Address - Country:US
Mailing Address - Phone:860-742-3543
Mailing Address - Fax:
Practice Address - Street 1:3 FARM GLEN BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1981
Practice Address - Country:US
Practice Address - Phone:860-742-3543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily