Active NPI
Kristin E Druien, CRNP
- Family Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1639613540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP01700
- Practice address
- 1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002 - Phone
- (215) 955-6844
- NPI assigned
- Dec 12, 2016
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP01700 | PA | Primary |
Addresses
Primary practice location
1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Mailing address
1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Other practice location 1
2301 S. Broad Street
1st Floor
Philadelphia, PA 19148-3542
Phone (215) 952-9136
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103283261 | Medicaid | PA | |
| 571896 | Other | PA | MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP01700 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1639613540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 SANSOM ST",
"address_2": "SUITE 239",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 SANSOM ST",
"address_2": "SUITE 239",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075002",
"telephone_number": "215-955-6844"
}
],
"practiceLocations": [
{
"address_1": "2301 S. Broad Street",
"address_2": "1st Floor",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191483542",
"country_code": "US",
"telephone_number": "215-952-9136",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DRUIEN",
"first_name": "KRISTIN",
"middle_name": "E",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-12",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP01700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103283261",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "571896",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.