Provider Demographics
NPI:1467888685
Name:HANSEN, KRISTIN L (NP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:HANSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE WELLNESS CENTER
Mailing Address - Street 2:229 MAIN STREET KEENE STATE COLLEGE
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03435-3241
Mailing Address - Country:US
Mailing Address - Phone:603-358-2200
Mailing Address - Fax:603-358-2444
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03435-0001
Practice Address - Country:US
Practice Address - Phone:508-450-0428
Practice Address - Fax:603-358-2444
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA204924363L00000X
NH078021-232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner