KRISTEN M DEROSA (NPI# 1003469230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003469230 |
| Entity Type | Individual |
| Full Name | KRISTEN M DEROSA |
| Credential | NNP-BC, ACNPC-AG |
| Practice Address |
416 Belmont St Worcester MA 01604-1086 |
| Mailing Address |
10 Damon Rd Holden MA 01520-2622 |
| Practice Telephone | 5087566609 |
| Mailing Telephone | 2024911043 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
45177 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATIONAL CERTIFICATION CORPORATION: CERTIFICATION ID | 104252227 | 01 | |
| NCC CERTIFICATION ID | 104252227 | 01 |
| Street Address |
416 BELMONT ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01604-1086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639231426 | Addie Lawrence | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2006-12-15 |
| 1548742364 | Florence Mumbi Gichuhi | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2018-08-29 |
| 1427576453 | Amanda Murray | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2017-08-30 |
| 1649641689 | Kathleen Marie Spadoni | Nurse Practitioner | 416 Belmont St, Worcester Internal Medicine, Worcester, MA 01604-1086 | 2015-10-16 |
| 1578956595 | Worcester Internal Medicine | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2015-03-16 |
| 1972938983 | Amanda Jane-bean Clancey | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2013-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1285123034 | Sandra Jean Golden | Social Worker | 240 Belmont Street, Worcester, MA 01604 | 2018-05-08 |
| 1669961348 | Cindy Truong Choe | Behavior Technician | 330 Southwest Cutoff Suite 203, Worcester, MA 01604 | 2018-05-08 |
| 1013412915 | Michelle Marie Gaudet | Behavioral Analyst | 330 Southwest Cutoff, Suite 203, Worcester, MA 01604 | 2018-03-24 |
| 1104336593 | Younghwa Kim | Counselor | 2 Granite Street, Worcester, MA 01604 | 2017-10-11 |
| 1134640857 | Desiree Oquendo | Developmental Therapist | 43 Dillon Street, Worcester, MA 01604 | 2017-07-03 |
| 1457803686 | Reliable Home Care Services | Foster Care Agency | 35a Houghton Strret, Worcester, MA 01604 | 2016-11-04 |
| 1639530876 | Emily Capstick | Counselor | 81 Plantation Steet, Worcester, MA 01604 | 2016-03-16 |
| 1144696519 | Christian Caban I | Developmental Therapist | 25 Orient St, Worcester, MA 01604 | 2015-08-19 |
| 1750770160 | Ayanna Ortiz | Developmental Therapist | 16 Bangor St, Worcester, MA 01604 | 2015-01-22 |
| Find all providers in zip 01604 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023538980 | Caitlin Paige Stavens-meucci | Nurse Practitioner | 119 Belmont St, Worcester, MA 01605-2903 | 2017-06-22 |
| 1043270622 | Michelle Stumm | Nurse Practitioner | 119 Belmont St, Worcester, MA 01605-2903 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629471008 | Krista Allison Kusinski | Nurse Practitioner | 759 Chestnut St # W2810, Springfield, MA 01107-1619 | 2014-09-30 |
| 1891114591 | Lisa Rivers | Nurse Practitioner | 141 High St, Medfield, MA 02052-3116 | 2014-04-09 |
| 1861790479 | Laura Susannah Tannenbaum | Nurse Practitioner | 100 Dow Ave, Arlington, MA 02476-7142 | 2011-03-05 |
| 1871619353 | Britt Frisk Pados | Nurse Practitioner | 162 Alder Rd, Westwood, MA 02090-3405 | 2007-03-22 |
| 1790211753 | Jemimah Joella Gracia Jurado | Nurse Practitioner | 759 Chestnut St, Springfield, MA 01107-1619 | 2017-05-11 |
| 1558720706 | Jeannie Marie Dodd | Nurse Practitioner | 759 Chestnut St, W2810, Springfield, MA 01199 | 2016-02-16 |
| 1467877423 | Angela Welker | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2014-02-27 |
| 1295169209 | Allyson R Hou | Nurse Practitioner | 759 Chestnut St, Springfield, MA 01199-1619 | 2013-08-27 |
| 1366883449 | Kathleen L Harris | Nurse Practitioner | 759 Chestnut St, Springfield, MA 01199-1619 | 2013-07-17 |
| 1336480250 | Tenielle Marie Langevin | Nurse Practitioner | 759 Chestnut St, Springfield, MA 01199-1619 | 2013-03-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.