Kristin Marie Longacre, R.N.

Individual provider Active NPI Registered Nurse · Hallstead, PA

NPI 1811547904 · NPPES record last updated Sep 19, 2019

Key facts

NPI
1811547904
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
411011 (NY)
Practice address
4121 Lower Rhiney Creek Rd
Hallstead, PA 18822-9006
Phone
(570) 967-2756
NPI assigned
Sep 19, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
411011NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 411011 NY Yes

Addresses

Primary practice location

4121 Lower Rhiney Creek Rd
Hallstead, PA 18822-9006

Mailing address

4121 Lower Rhiney Creek Rd
Hallstead, PA 18822-9006
Phone (570) 967-2756

Other providers in Hallstead, PA

All providers in Hallstead, PA · Registered Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.