1659422426 NPI number — MRS. KRISTINE BECKVAR VANLENTEN NP-C, APRN, BC

Table of content: MRS. KRISTINE BECKVAR VANLENTEN NP-C, APRN, BC (NPI 1659422426)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659422426 NPI number — MRS. KRISTINE BECKVAR VANLENTEN NP-C, APRN, BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANLENTEN
Provider First Name:
KRISTINE
Provider Middle Name:
BECKVAR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP-C, APRN, BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BECKVAR
Provider Other First Name:
KRISTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659422426
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 OLD OAKEN BUCKET RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCITUATE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02066-4435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-545-5987
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
950 WINTER ST
Provider Second Line Business Practice Location Address:
SUITE 3800
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02451-1424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-492-8792
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  135094 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 135094 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MV0019946I . This is a "STATE CONTROLLED SUB. REG" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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