Provider Demographics
NPI:1235467101
Name:WEBER, KRISTEN ELLIZABETH (CPNP MSN RN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELLIZABETH
Last Name:WEBER
Suffix:
Gender:F
Credentials:CPNP MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1628
Mailing Address - Country:US
Mailing Address - Phone:781-234-1931
Mailing Address - Fax:
Practice Address - Street 1:541 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1628
Practice Address - Country:US
Practice Address - Phone:781-234-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273896363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics