Provider Demographics
NPI:1780407262
Name:MCLOUGHLIN, KRIS A (DNP, APRN, PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:A
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:DNP, APRN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 CONNECTICUT AVE NW APT 1126
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5126
Mailing Address - Country:US
Mailing Address - Phone:808-226-0671
Mailing Address - Fax:
Practice Address - Street 1:3133 CONNECTICUT AVE NW APT 1126
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5126
Practice Address - Country:US
Practice Address - Phone:808-226-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1044677364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health