Individual
KRISTEN KALA DESANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP, BC
Contact information
Practice address
55 FRUIT STREET, ATTN: CENTRAL CREDENTIALING OFFICE, BOSTON, MA 02114
(617) 726-2212
Mailing address
11 REVERE ST APT 3, BOSTON, MA 02114-3812
(540) 664-4846
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
549912241844
MA
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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