KRISTINE MARIE HACKETT (NPI# 1770579328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770579328 |
| Entity Type | Individual |
| Full Name | KRISTINE MARIE HACKETT |
| Credential | WHNP |
| Practice Address |
90 Hope Dr 366th Mdg/surgical Operations Squadron Mountain Home Afb ID 83648-1057 |
| Mailing Address |
90 Hope Drive 366th Surgical Operations Squadron Mountain Home Afb ID 83648 |
| Practice Telephone | 2088287534 |
| Mailing Telephone | 2088287534 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2014-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
RN-292179 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011320 | Kristine Marie Hackett | Optometrist | 19301 Se 34th St Ste 104, Camas, WA 98607-8881 | 2020-07-30 |
| Street Address |
90 HOPE DR 366TH MDG/SURGICAL OPERATIONS SQUADRON |
| City | MOUNTAIN HOME AFB |
| State | ID |
| Zip Code | 83648-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487200036 | Terrance Valdespino | Dental Assistant | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2019-08-09 |
| 1497215982 | Janette Sue Cooke | Dietitian, Registered | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2019-03-21 |
| 1598224602 | Cody James Murray | Dentist | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2019-03-18 |
| 1922585140 | Heather Ford | Military Health Care Provider | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2018-07-20 |
| 1639664006 | Paul Sahwell | Psychologist | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2018-06-27 |
| 1528551751 | Ryan D Kainrath | Military Health Care Provider | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2018-06-12 |
| 1265948897 | Alyse Marie Denittis | Physician Assistant | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-12-19 |
| 1891224473 | Jared Getzlaff | Military Health Care Provider | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-06-07 |
| 1548796527 | Derek J Dutson | Dentist | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2017-05-11 |
| 1093109449 | Andrea Lynn Moore | Student in an Organized Health Care Education/Training Program | 90 Hope Dr, Mountain Home Afb, ID 83648 | 2015-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851528392 | Amy Jo Glover | Military Health Care Provider | 90 Hope Dr. Bldg 6000, Mountain Home, ID 83648 | 2009-06-11 |
| 1306051065 | Thomas Michael Smith | Social Worker | 90 Hope Dr Bldg 1900, Mountain Home Afb, ID 83648 | 2007-05-14 |
| 1316005143 | Ronald Wesley Bailey | Radiology | Mountain Home Afb Medical Group, 90 Hope Drive, Building 6000, Mountain Home Afb, ID 83648 | 2006-12-05 |
| 1992780597 | Randall Jay Moore | Preventive Medicine | 366mdg/sgpf, 90 Hope Drive; Bldg 6000, Mountain Home Afb, ID 83648 | 2005-12-07 |
| 1356325666 | Joseph Carroll Skinner Jr. | Nurse Anesthetist, Certified Registered | 366 Mdos, Sgosa, 90 Hope Drive, Mountain Home Afb, ID 83648 | 2005-11-30 |
| 1023007846 | Craig Loyd Folsom | Dentist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2005-10-14 |
| 1477547271 | Ron Stumbo | Pharmacist | Mountain Home Afb, Mountain Home Afb, ID 83648 | 2005-09-07 |
| 1154315943 | Georgette Ann Trezvant | Social Worker | 366 Medical Operations Squadron, 90 Hope Drive, Bldg 6000, Mt. Home Air Force Base, ID 83648 | 2005-09-07 |
| 1164893202 | Craig Jensen | Optometrist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2015-10-15 |
| 1730582438 | Kyle Christensen | Dentist | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648 | 2014-10-08 |
| Find all providers in zip 83648 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669722781 | Leslie Lyn Balcazar | Nurse Practitioner | 90 Hope Dr, Bldg 6000, Mountain Home Afb, ID 83648-1057 | 2012-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356678106 | Clea K. Mefford | Nurse Practitioner | 1408 Pomerelle Ave # H, Burley, ID 83318-2064 | 2009-11-13 |
| 1477714285 | Kara Kelly Hill | Nurse Practitioner | 111 Main St Ste 100, Boise, ID 83702-7307 | 2008-06-24 |
| 1265617849 | Selkirk Family Medicine & Womens Health Pllc | Nurse Practitioner | 1215 Michigan St Ste C, Sandpoint, ID 83864-5014 | 2008-01-02 |
| 1538238506 | Pamela Jan Tilaro | Nurse Practitioner | 8500 N. Atlas Rd, Hayden, ID 83835-8332 | 2006-11-06 |
| 1922197946 | Cynthia W Dalsing | Nurse Practitioner | 1215 Michigan St, Suite C, Sandpoint, ID 83864-5014 | 2006-10-11 |
| 1144325572 | Annie C Fife | Nurse Practitioner | 500 W. Fort St, Boise, ID 83702 | 2006-09-13 |
| 1679688030 | Healing Arts Women's Clinic, Pa | Nurse Practitioner | 222 W Iowa Ave Ste 225, Nampa, ID 83686-6815 | 2006-08-19 |
| 1508886425 | Mary Gerard Battaglia | Nurse Practitioner | 1112 Ironwood Dr, Coeur D Alene, ID 83814 | 2006-07-21 |
| 1013936541 | Susan P Stutzman | Nurse Practitioner | 215 10th St, Lewiston, ID 83501-1912 | 2006-07-18 |
| 1871560995 | Mary R Fiedler | Nurse Practitioner | 1020 Michigan St, Sandpoint, ID 83864-1788 | 2006-03-07 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME AFB |
| Zip Code | 83648 |
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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.