Active NPI
Kristen Marie Wiese, R.PH
- Pharmacist
- Stafford Springs, CT
National Provider Identifier
1932497369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7900
- Practice address
- 88 W Stafford Rd
Rite Aid Pharmacy 4759
Stafford Springs, CT 06076-1067 - Phone
- (860) 684-9555
- NPI assigned
- Jul 19, 2011
- Last updated
- Jul 19, 2011
- 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 | 7900 | CT | Primary |
Addresses
Primary practice location
88 W Stafford Rd
Rite Aid Pharmacy 4759
Stafford Springs, CT 06076-1067
Mailing address
32 Lancaster Rd
Coventry, CT 06238-1336
Phone (860) 742-4431
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7900 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1932497369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 LANCASTER RD",
"city": "COVENTRY",
"state": "CT",
"postal_code": "062381336",
"telephone_number": "860-742-4431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 W STAFFORD RD",
"address_2": "RITE AID PHARMACY 4759",
"city": "STAFFORD SPRINGS",
"state": "CT",
"postal_code": "060761067",
"telephone_number": "860-684-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESE",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "7900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford Springs, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.