Healthcare Provider Details

I. General information

NPI: 1033404298
Provider Name (Legal Business Name): KRISTEN L. BARLETTA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WEBSTER ST STE 8
HANOVER MA
02339-1227
US

IV. Provider business mailing address

105 WEBSTER ST STE 8
HANOVER MA
02339-1227
US

V. Phone/Fax

Practice location:
  • Phone: 781-754-6545
  • Fax: 781-536-0016
Mailing address:
  • Phone: 781-754-6545
  • Fax: 781-536-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2264507
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: