KRISTIN MARIE PELLETIER (NPI# 1104343045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104343045 |
| Entity Type | Individual |
| Full Name | KRISTIN MARIE PELLETIER |
| Credential | IBCLC |
| Practice Address |
2113 Highland Ridge Dr Phoenix MD 21131-1217 |
| Mailing Address |
3 Windsor Ct Farmington CT 06032-1458 |
| Practice Telephone | 4104430022 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
085071 | CT | Nursing Service Providers |
| Street Address |
2113 HIGHLAND RIDGE DR |
| City | PHOENIX |
| State | MD |
| Zip Code | 21131-1217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124309430 | Amanda Brady Watters Gorman | Registered Nurse | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2011-08-31 |
| 1366952657 | Ann Bennett | Lactation Consultant, Non-RN | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-10-02 |
| 1740729466 | Gorman and Associates, LLC | Nurse Practitioner | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114118387 | Mina Kirkova | Social Worker | 3009 Jackson Ridge Ct, Phoenix, MD 21131 | 2007-08-05 |
| 1629101381 | Kenneth Barry Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-13 |
| 1508999798 | Nancy Lee Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-14 |
| 1093977134 | Amy Ruth Rakusin | Counselor | 10 Cross Creek Ct, Phoenix, MD 21131-1000 | 2008-06-30 |
| 1932493616 | Kenneth Sharoff, Phd Inc. | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131-1000 | 2011-05-31 |
| 1063608735 | Catherine Anderson North | Radiology | 1410 Phoenix Rd W, Phoenix, MD 21131-1024 | 2007-09-17 |
| 1528482643 | Charles Warnke | Speech-Language Pathologist | 13 Stonewood Ct, Phoenix, MD 21131-1116 | 2014-02-10 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1952775694 | Aileen Mccausland | Occupational Therapy Assistant | 2515 Stockton Rd, Phoenix, MD 21131-1127 | 2015-11-18 |
| 1700131919 | Gina Hoag | Social Worker | 15 Fairwood View Ct, Phoenix, MD 21131-1301 | 2012-07-13 |
| Find all providers in zip 21131 | ||||
| Taxonomy Code | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224917 | Lauren Lyell | Registered Nurse | 1249 E Tonto Ln, Phoenix, AZ 85024-1770 | 2020-10-30 |
| 1184834350 | Voni Jo Miller | Registered Nurse | 1901 E Lamar Rd, Phoenix, AZ 85016-1136 | 2007-05-23 |
| 1659918357 | Rebecca Lynn Bandeen | Registered Nurse | 6610 W Cordia Ln, Phoenix, AZ 85083-7404 | 2019-12-02 |
| 1720461114 | Ruby Rachel Samaniego | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2015-07-02 |
| 1295136463 | Michaela Wagner | Registered Nurse | 8410 W Thomas Rd, Ste 137, Phoenix, AZ 85037-3374 | 2014-09-08 |
| 1427323989 | Jolene B Edwards | Registered Nurse | 215 E Lexington Ave, Phoenix, AZ 85012-2321 | 2012-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104424365 | Prolactin Life, LLC | Registered Nurse | 15012 Notley Rd, Silver Spring, MD 20905-7437 | 2020-10-10 |
| 1447861554 | Emily Margaret Johnson | Registered Nurse | 509 Casey Ln, Rockville, MD 20850-7744 | 2020-08-12 |
| 1770101180 | Kelly Kendall | Registered Nurse | 1782 E Regents Park Rd, Crofton, MD 21114-2530 | 2020-07-13 |
| 1841810546 | Kristan Nichole Zylka | Registered Nurse | 253 Bell Rd, Westminster, MD 21158-4107 | 2020-04-22 |
| 1174152912 | Melissa Marie Wilson | Registered Nurse | 905 Forksbridge Ct, Gambrills, MD 21054-1655 | 2020-04-03 |
| 1588209100 | Nancy Jill Kerr | Registered Nurse | 616 Laurel Dr, Pasadena, MD 21122-5225 | 2019-11-07 |
| 1245886944 | Christina Louise Bernard | Registered Nurse | 777 Oakwilde Way, Millersville, MD 21108-1417 | 2019-08-18 |
| 1770137440 | Jaime Samluck | Registered Nurse | 620 Trango Dr, Westminster, MD 21158-9469 | 2019-07-30 |
| 1194382515 | Bridget N Krautwurst | Registered Nurse | 33 Boileau Ct, Middletown, MD 21769-8002 | 2019-05-21 |
| 1881156784 | Anne Caitlin Greene | Registered Nurse | 14812 Physicians Ln Ste 161, Rockville, MD 20850-3911 | 2019-04-01 |
| 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.