Healthcare Provider Details

I. General information

NPI: 1972481091
Provider Name (Legal Business Name): KRISI GJINI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 SOLDIERS FIELD RD STE 3
BOSTON MA
02135-1000
US

IV. Provider business mailing address

1340 SOLDIERS FIELD RD STE 3
BOSTON MA
02135-1000
US

V. Phone/Fax

Practice location:
  • Phone: 866-510-3002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberRN2305447
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: