Healthcare Provider Details

I. General information

NPI: 1962956649
Provider Name (Legal Business Name): KRISTIE M HARRINGTON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 04/14/2024
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 MAIN ST
SPRINGFIELD MA
01104-3566
US

IV. Provider business mailing address

2150 MAIN ST STE 110
SPRINGFIELD MA
01104-3300
US

V. Phone/Fax

Practice location:
  • Phone: 413-736-1500
  • Fax: 413-736-1600
Mailing address:
  • Phone: 413-736-1500
  • Fax: 413-736-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2274356
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: