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General NPI Number Information
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NPI Number | 1679168983
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Entity Type | Individual
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Provider Name | KRISTEN N/A KOWAL
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Gender | Female
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 1515 ALLEN ST
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City | SPRINGFIELD
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State | MA
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Zip | 01118-1803
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Country | US
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Telephone | 413-783-9114
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Fax |
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Provider Business Mailing Address
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Address Line | 16 LINCOLN ST
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City | CHICOPEE
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State | MA
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Zip | 01020-2519
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Country | US
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Telephone | 413-297-4001
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2260258
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License Number State | MA
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