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 1:463 WASHINGTON ST OFC 1
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2745
Mailing Address - Country:US
Mailing Address - Phone:603-333-1490
Mailing Address - Fax:802-200-5623
Practice Address - Street 1:463 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2745
Practice Address - Country:US
Practice Address - Phone:603-333-1490
Practice Address - Fax:802-200-5623
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204924363L00000X
NH078021-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner