Provider Demographics
NPI:1225168644
Name:LUNDSTED, KRISTIN BETH
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:BETH
Last Name:LUNDSTED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ASHLEE DR
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-2246
Mailing Address - Country:US
Mailing Address - Phone:603-924-0098
Mailing Address - Fax:
Practice Address - Street 1:456 OLD STREET RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1265
Practice Address - Country:US
Practice Address - Phone:603-924-8620
Practice Address - Fax:603-924-0155
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH035534-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse