Most Relevant Information
Provider Data
| NPI Number: | 1003469230 |
| Provider Name: | KRISTEN M DEROSA NNP-BC, ACNPC-AG |
| Entity Type: | Individual |
| Taxonomy Code: | 363LN0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 45177 |
Most Important Dates
| Enumeration Date: | 07/17/2019 |
| Last Updated: | 07/17/2019 |
Provider Practice Location
416 BELMONT ST
WORCESTER
MA
016041086
Practice Location Phone/Fax
| Phone: | 5087566609 |
| Fax: |
Provider Mailing Location
10 DAMON RD
HOLDEN
MA
015202622
Provider Mailing Phone/Fax
| Phone: | 2024911043 |
| Fax: |