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NPI Code Detail

MEDICARE: KRISTEN LARAIA RN

MEDICARE: KRISTEN LARAIA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN2316862MA

General Provider Information

NPI Number : 1255012563
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN LARAIA RN
Provider Business Mailing Address
First Line : 600 BULFINCH DR APT 308
Second Line :
City : ANDOVER
State : MA
Zip : 01810-1129
Country : US
Telephone Number : 774-644-7731
Fax Number :
Provider Business Practice Location Address
First Line : 600 BULFINCH DR APT 308
Second Line :
City : ANDOVER
State : MA
Zip : 01810-1129
Country : US
Telephone Number : 774-644-7731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2023
Last Update Date : 07/28/2023

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