Individual provider Active NPI

Kristen Joan Pettine, RNFA

  • Registered Nurse First Assistant
  • Paoli, PA
National Provider Identifier
1063342988
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN589167 Issued in PA
Practice address
4 Industrial Blvd
Paoli, PA 19301-1605
Phone
(610) 644-6900
NPI assigned
May 21, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 163WR0006X RN589167 PA Primary

Addresses

Primary practice location

4 Industrial Blvd
Paoli, PA 19301-1605

Mailing address

2400 Villa Dr
Pottstown, PA 19464-2017
Phone (610) 256-2682

Other practice location 1

491 John Young Way
Exton, PA 19341-2567
Phone (484) 872-8408

Other practice location 2

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1000

Other practice location 3

1230 American Blvd
West Chester, PA 19380-4264
Phone (484) 473-6050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN589167PAMDRegistered Nurse First Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1063342988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 VILLA DR",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194642017",
            "telephone_number": "610-256-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 INDUSTRIAL BLVD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011605",
            "telephone_number": "610-644-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "491 John Young Way",
            "address_purpose": "LOCATION",
            "city": "Exton",
            "state": "PA",
            "postal_code": "193412567",
            "country_code": "US",
            "telephone_number": "484-872-8408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 W Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Paoli",
            "state": "PA",
            "postal_code": "193011763",
            "country_code": "US",
            "telephone_number": "484-565-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 American Blvd",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193804264",
            "country_code": "US",
            "telephone_number": "484-473-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTINE",
        "first_name": "KRISTEN",
        "middle_name": "JOAN",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "PA",
            "license": "RN589167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.