Provider Demographics
NPI:1902348642
Name:HASTINGS, KRISTEN LOUISE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LOUISE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COMMONWEALTH AVE
Mailing Address - Street 2:20 BOYDEN BUILDING
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9253
Mailing Address - Country:US
Mailing Address - Phone:413-545-4093
Mailing Address - Fax:
Practice Address - Street 1:131 COMMONWEALTH AVE
Practice Address - Street 2:20 BOYDEN BUILDING
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9253
Practice Address - Country:US
Practice Address - Phone:413-545-4093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer