Provider Demographics
NPI:1447797048
Name:FALCAO, KRISTY MARIE (RN, NP)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARIE
Last Name:FALCAO
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:MAIRE
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1029 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324
Mailing Address - Country:US
Mailing Address - Phone:508-697-8116
Mailing Address - Fax:
Practice Address - Street 1:303 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-1752
Practice Address - Country:US
Practice Address - Phone:508-226-0780
Practice Address - Fax:508-226-8552
Is Sole Proprietor?:No
Enumeration Date:2017-01-21
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN 2276873163W00000X
MARN2276873363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse