Provider Demographics
NPI:1801521612
Name:ADAMS, KRISTY (CNP)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3A BYRNE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02576-1010
Mailing Address - Country:US
Mailing Address - Phone:508-287-2780
Mailing Address - Fax:
Practice Address - Street 1:1029 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2472
Practice Address - Country:US
Practice Address - Phone:508-697-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN263746363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner