Provider Demographics
NPI:1669596946
Name:HARTE, KRISTEN LYN (NP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYN
Last Name:HARTE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2 1ST AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4962
Mailing Address - Country:US
Mailing Address - Phone:978-740-2300
Mailing Address - Fax:978-744-3993
Practice Address - Street 1:2 1ST AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4959
Practice Address - Country:US
Practice Address - Phone:978-740-2300
Practice Address - Fax:978-744-3993
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2017-03-09
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Provider Licenses
StateLicense IDTaxonomies
MA200642363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3287Medicare UPIN
MANP3287Medicare UPIN