Provider Demographics
NPI:1942228135
Name:HAMLIN-PASSES, KRISTIN RENEE' (APRN,BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:RENEE'
Last Name:HAMLIN-PASSES
Suffix:
Gender:F
Credentials:APRN,BC
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 1586
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56619-1586
Mailing Address - Country:US
Mailing Address - Phone:218-751-2786
Mailing Address - Fax:
Practice Address - Street 1:HWY 1
Practice Address - Street 2:
Practice Address - City:RED LAKE
Practice Address - State:MN
Practice Address - Zip Code:56671
Practice Address - Country:US
Practice Address - Phone:218-679-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110566363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP89760Medicare UPIN
MN240206Medicare Oscar/Certification
MN8HE388Medicare PIN