Individual
KRISTIN J ISHAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-2686
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-2686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN212307
MA
363LF0000X
Family Nurse Practitioner
RN212307
MA
Other
Enumeration date
01/30/2017
Last updated
12/08/2017
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