Healthcare Provider Details

I. General information

NPI: 1275314833
Provider Name (Legal Business Name): KRISTIN D CABOT MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 MERRIAM AVE STE 101
LEOMINSTER MA
01453-3175
US

IV. Provider business mailing address

114 MERRIAM AVE STE 101
LEOMINSTER MA
01453-3175
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-3399
  • Fax: 978-537-4929
Mailing address:
  • Phone: 978-534-3399
  • Fax: 978-537-4929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN260756
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN260756
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: