Individual
MS. KRISTIN EVANS LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1245 ELM ST, MANCHESTER, NH 03101-1308
(603) 668-6629
Mailing address
1245 ELM ST, MANCHESTER, NH 03101-1308
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
067122-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3086998
—
NH
Enumeration date
06/24/2013
Last updated
02/16/2018
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