Provider Demographics
NPI:1477710515
Name:CAMARA, KRISTEN J (CNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:J
Last Name:CAMARA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:J
Other - Last Name:PALERMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:101 MAIN ST STE 214
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4530
Mailing Address - Country:US
Mailing Address - Phone:781-391-3885
Mailing Address - Fax:781-391-6224
Practice Address - Street 1:101 MAIN ST STE 214
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4530
Practice Address - Country:US
Practice Address - Phone:781-391-3885
Practice Address - Fax:781-391-6224
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2291157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily