Individual
KRISTIN FARRELL WASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
725 ALBANY ST, GENERAL INTERNAL MEDICINE, BOSTON, MA 02118-2526
(617) 414-5951
(617) 414-9157
Mailing address
801 MASSACHUSETTS AVE, SECOND FLOOR, SUITE 2027D, BOSTON, MA 02118-2605
(617) 414-4176
(617) 414-4231
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
RN2262692
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2262692
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110122621A
—
MA
Enumeration date
02/10/2017
Last updated
09/28/2017
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