Active NPI
Kristin Lee Waller
- Pharmacist
- Hooksett, NH
National Provider Identifier
1588071229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3964
- Practice address
- 100 Quality Dr
Hooksett, NH 03106-2651 - Phone
- (207) 209-9389
- NPI assigned
- Jul 15, 2014
- Last updated
- Jul 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3964 | NH | Primary |
Addresses
Primary practice location
100 Quality Dr
Hooksett, NH 03106-2651
Mailing address
100 Quality Dr
Hooksett, NH 03106-2651
Phone (207) 209-9389
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3964 | Other | NH | NEW HAMPSHIRE PHARMACY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3964 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1588071229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 QUALITY DR",
"city": "HOOKSETT",
"state": "NH",
"postal_code": "031062651",
"telephone_number": "207-209-9389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 QUALITY DR",
"city": "HOOKSETT",
"state": "NH",
"postal_code": "031062651",
"telephone_number": "207-209-9389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER",
"first_name": "KRISTIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-15",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW HAMPSHIRE PHARMACY LICENSE",
"identifier": "3964",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hooksett, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.