Provider Demographics
NPI:1992866016
Name:AINSWORTH QUINTAL, KRISTINE M (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:AINSWORTH QUINTAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:565 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1048
Practice Address - Country:US
Practice Address - Phone:603-578-3347
Practice Address - Fax:603-578-3387
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH024479-21163W00000X
NH024479-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203623Medicaid
NH4007048Y0NH04OtherANTHEM
MA0711764Medicaid
NHNP1077Medicare PIN
MA0711764Medicaid