Kristine Marie Hackett, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN-292179 Issued in OH

Practice address

90 Hope Dr
366TH MDG/Surgical Operations Squadron
Mountain Home Afb, ID 83648-1057

Phone

(208) 828-7534

NPI assigned

Sep 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1770579328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOPE DRIVE",
            "address_2": "366TH SURGICAL OPERATIONS SQUADRON",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "83648",
            "telephone_number": "208-828-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "address_2": "366TH MDG/SURGICAL OPERATIONS SQUADRON",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "836481057",
            "telephone_number": "208-828-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "RN-292179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Funk, MS, RDN, LDN
• Eric Nathain Galindo Jr., IDMT
• Branyan Decarlo Garcia, FNP
• Zachery Orion Glickman
• Aspen Claire Guthrie, DSC, MPT
• Judy Ann Hafner, PSYD
• Nicholas Michael Harrison, D.M.D.
• Allen William Hauser, PHARMD
• Debra E Hayton, LCSW
• Linda J Hensley, NURSE PRACTITIONER

• Women's Health Nurse Practitioner in Mountain Home Afb, ID
• Providers in Mountain Home Afb, ID by specialty
• Women's Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.