MEDICARE: BETTE KISNER APRN-BC,MSN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	98955	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PN0250	OTHER	MA	BLUE CROSS

General Provider Information

NPI Number	:	1659326072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTE KISNER APRN-BC,MSN

Provider Business Mailing Address
First Line	:	163 HIGHLAND AVE # 1040
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3025
Country	:	US
Telephone Number	:	617-840-3250
Fax Number	:	617-739-6225

Provider Business Practice Location Address
First Line	:	163 HIGHLAND AVE # 1040
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3025
Country	:	US
Telephone Number	:	617-840-3250
Fax Number	:	617-739-6225

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/15/2026

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