Provider Demographics
NPI:1013975424
Name:FERREIRA, KRISTEN (FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MT AUBURN ST
Mailing Address - Street 2:PARSONS 2
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5597
Mailing Address - Country:US
Mailing Address - Phone:617-499-5083
Mailing Address - Fax:
Practice Address - Street 1:625 MOUNT AUBURN ST STE 106
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4556
Practice Address - Country:US
Practice Address - Phone:617-661-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN234490363L00000X, 363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0385701Medicaid
MA0385701Medicaid
MANP2818Medicare ID - Type Unspecified