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NPI 1003317546

NPI 1003317546 : KRISTIE N LA MONICA PA : KEENE, NH

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General NPI Number Information
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    NPI Number           |    1003317546
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTIE N LA MONICA PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/21/2018
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    Last Update Date     |    01/08/2026
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Provider Practice Location Address
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    Address Line         |    590 COURT ST 
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    City                 |    KEENE
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    State                |    NH
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    Zip                  |    03431
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    Country              |    US
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    Telephone            |    603-354-5496
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    54 BAKER AVENUE EXT STE 203 
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    City                 |    CONCORD
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    State                |    MA
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    Zip                  |    01742-2137
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    1347
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    License Number State |    NH
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Taxonomy #2
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    7339
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    License Number State |    MA
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