Provider Demographics
NPI:1104377365
Name:LUNDSTEN, KRISTIN (DNP, MSN, PMNP-BC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:LUNDSTEN
Suffix:
Gender:F
Credentials:DNP, MSN, PMNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHRISTINE DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3226
Mailing Address - Country:US
Mailing Address - Phone:401-603-6234
Mailing Address - Fax:
Practice Address - Street 1:400 MASSASOIT AVE STE 305
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2012
Practice Address - Country:US
Practice Address - Phone:401-294-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN36091163W00000X
RIAPRN02640363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse