Individual
KRISTEN M DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP-BC, ACNPC-AG
Contact information
Practice address
416 BELMONT ST, WORCESTER, MA 01604-1086
(508) 756-6609
Mailing address
67 MILLBROOK ST STE 406A, WORCESTER, MA 01606-2845
(508) 283-4513
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN2314768
MA
363LN0000X
Neonatal Nurse Practitioner
45177
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104252227
NATIONAL CERTIFICATION CORPORATION: CERTIFICATION ID
—
Enumeration date
07/17/2019
Last updated
02/20/2025
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