Provider Demographics
NPI:1528887221
Name:DREIST, KRISTI RENE'E
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:RENE'E
Last Name:DREIST
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 1:334 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2541
Mailing Address - Country:US
Mailing Address - Phone:508-577-3717
Mailing Address - Fax:
Practice Address - Street 1:1 DONALDS WAY STE 208
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1478
Practice Address - Country:US
Practice Address - Phone:781-878-1701
Practice Address - Fax:781-871-0312
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN100284164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse