Provider Demographics
NPI:1508374406
Name:CHOUINARD, KRISTIN TYRRELL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:TYRRELL
Last Name:CHOUINARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARE DIMENSIONS
Mailing Address - Street 2:75 SYLVAN ST. STE B102
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2709
Mailing Address - Country:US
Mailing Address - Phone:888-281-0011
Mailing Address - Fax:
Practice Address - Street 1:HOME MD
Practice Address - Street 2:75 SYLVAN ST.
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-0192
Practice Address - Country:US
Practice Address - Phone:888-281-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-14
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263142363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology