MEDICARE: KRISTEN ANN LANCTOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZA2600X	Medical Art Specialist/Technologist	TA00900	RI

General Provider Information

NPI Number	:	1679165799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN ANN LANCTOT

Provider Business Mailing Address
First Line	:	100 SPRING WATER DR
Second Line	:
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-4967
Country	:	US
Telephone Number	:	401-432-4976
Fax Number	:

Provider Business Practice Location Address
First Line	:	2364 DIAMOND HILL RD
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-4739
Country	:	US
Telephone Number	:	401-764-8556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	03/04/2023

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Directions to “ KRISTEN ANN LANCTOT ” Practice Location

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