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General NPI Number Information
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NPI Number | 1780650234
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Entity Type | Individual
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Provider Name | KRISTAL L IMPERIO NP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 165 MILL ST
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-466-3212
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Fax | 978-534-3581
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Provider Business Mailing Address
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Address Line | 630 PLANTATION ST
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City | WORCESTER
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State | MA
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Zip | 01605
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Country | US
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Telephone | 978-466-3212
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Fax | 978-534-3581
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 198129
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License Number State | MA
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