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General NPI Number Information
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NPI Number | 1487075347
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Entity Type | Individual
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Provider Name | KRISTIN O'HARA
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Gender | Female
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 489 BEARSES WAY UNIT A-4
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City | HYANNIS
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State | MA
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Zip | 02601-2707
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Country | US
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Telephone | 508-771-4092
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Fax | 508-771-9466
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Provider Business Mailing Address
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Address Line | 98 DEERFOOT CIR
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City | MASHPEE
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State | MA
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Zip | 02649-2440
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Country | US
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Telephone | 508-801-3260
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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 | PA1439
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License Number State | ME
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