Provider Demographics
NPI:1891889762
Name:KASPER, HALLIE BIEBER (NP)
Entity Type:Individual
Prefix:MRS
First Name:HALLIE
Middle Name:BIEBER
Last Name:KASPER
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 1:90 WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3210
Mailing Address - Country:US
Mailing Address - Phone:617-969-6130
Mailing Address - Fax:617-928-1450
Practice Address - Street 1:30 FRUIT ST
Practice Address - Street 2:FHBURR PROTON CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2620
Practice Address - Country:US
Practice Address - Phone:617-643-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233937363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11019507AMedicaid