Individual
MRS. KRISTAN MARIE BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
300 LONGWOOD AVE, MAIN BUILDING, 7 NORTH NICU, BOSTON, MA 02115-5724
(617) 355-8076
(617) 730-0902
Mailing address
300 LONGWOOD AVE, MAIN BUILDING, 7 NORTH NICU, BOSTON, MA 02115-5724
(617) 355-8076
(617) 730-0902
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN259832
MA
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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