Healthcare Provider Details

I. General information

NPI: 1013732437
Provider Name (Legal Business Name): KRISTEN ROBERTS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6106
US

IV. Provider business mailing address

139 ELM ST APT 1
SOMERVILLE MA
02144-3163
US

V. Phone/Fax

Practice location:
  • Phone: 877-442-3324
  • Fax:
Mailing address:
  • Phone: 619-346-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: