KRISTEN M DEROSA


Address: 416 Belmont St, Worcester, MA 01604-1086
Phone: 5087566609

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LN0000X Nurse Practitioner
Specialization: Neonatal
45177 KS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NATIONAL CERTIFICATION CORPORATION: CERTIFICATION ID 104252227 01
NCC CERTIFICATION ID 104252227 01

Office Location

Street Address 416 BELMONT ST
City WORCESTER
State MA
Zip Code 01604-1086

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LN0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Neonatal

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City WORCESTER
Zip Code 01604

Improve Information

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Dataset Information

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.

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