Provider Demographics
NPI:1881164184
Name:AMARAL, KRISTINA V (CNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:V
Last Name:AMARAL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:VIVEIROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-973-1020
Practice Address - Fax:508-973-1025
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN252872363LA2100X, 208600000X
MARN25872363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery