Provider Demographics
NPI:1558620898
Name:ALEVA, KRISTEN JILL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JILL
Last Name:ALEVA
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:PO BOX 18
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-0018
Mailing Address - Country:US
Mailing Address - Phone:207-558-2922
Mailing Address - Fax:207-560-9124
Practice Address - Street 1:178 DOW HWY STE 12
Practice Address - Street 2:
Practice Address - City:ELIOT
Practice Address - State:ME
Practice Address - Zip Code:03903-2047
Practice Address - Country:US
Practice Address - Phone:207-558-2922
Practice Address - Fax:207-560-9124
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH041737-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHF05063Medicare UPIN
NHNH6903Medicare PIN