MEDICARE: KRISTINE HARRIS N.P.

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
1	163W00000X	Registered Nurse	211982	MA
2	364SA2200X	Adult Health Clinical Nurse Specialist	RN211982	MA

General Provider Information

NPI Number	:	1629476189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE HARRIS N.P.

Provider Business Mailing Address
First Line	:	120 WATER ST
Second Line	:	SUITE 404
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-2648
Country	:	US
Telephone Number	:	978-685-2460
Fax Number	:	978-685-2572

Provider Business Practice Location Address
First Line	:	120 WATER ST
Second Line	:	SUITE 404
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-2648
Country	:	US
Telephone Number	:	978-685-2460
Fax Number	:	978-685-2572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	12/16/2014

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