KRISTIN L MANNKE NPI 1376971838

NPI Information

NPI: 1376971838
Provider Name: KRISTIN L MANNKE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: MYSTIC VALLEY DERMATOLOGY ASSOCIATES, P.C.

PECOS Registration: Yes

Address:
LAHEY HOSPITAL AND MEDICAL CENTER
67 S. BEDFORD STREET- DERMATOLOGY DEPARTMENT
BURLINGTON, MA
ZIP 01803
Phone: (781) 744-5115
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Kristin L Mannke is a family nurse practitioner in Burlington, MA with 11 years of experience. Kristin L Mannke NPI is 1376971838. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2013

The provider's business location address is:

LAHEY HOSPITAL AND MEDICAL CENTER
67 S. BEDFORD STREET- DERMATOLOGY DEPARTMENT
BURLINGTON, MA
ZIP 01803-108
Phone: (781) 744-5115
Fax: (781) 744-5687

The NPI 1376971838 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/21/2013 and was last updated on 5/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	201393178NP-PP	OREGON	No
2	363LF0000X	Nurse Practitioner	Family	RN262875	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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