KRISTIN MICHELE DETLEFSEN PA-C NPI 1457436354

NPI Information

NPI: 1457436354
Provider Name: KRISTIN MICHELE DETLEFSEN, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
100 HITCHCOCK WAY
MANCHESTER, NH
ZIP 03104
Phone: (603) 695-2500
Get Directions

Kristin Michele Detlefsen, PA-C is a surgical physician assistant in Manchester, NH. Kristin Michele Detlefsen, PA-C NPI is 1457436354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 HITCHCOCK WAY
MANCHESTER, NH
ZIP 03104-125
Phone: (603) 695-2500

The enumeration date for this NPI number is 10/26/2006 and was last updated on 6/23/2014.

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	363AM0700X	Physician Assistant	Medical	0604	NEW HAMPSHIRE	No
2	363AS0400X	Physician Assistant	Surgical	0604	NEW HAMPSHIRE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0002768	MEDICARE PIN	NEW HAMPSHIRE
2	30336099	MEDICAID	NEW HAMPSHIRE
3	3076097	MEDICAID	NEW HAMPSHIRE

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: 4/28/2024

NPI Synchronization or Removal

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