=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619819232
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTY HURLEY BENNETT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2026
-----------------------------------------------------
Last Update Date | 04/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 POND PARK RD
-----------------------------------------------------
City | HINGHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02043-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-624-2769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 BOG VIEW RD
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02364-2064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-624-2769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN265153
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------