Provider Demographics
NPI:1215529847
Name:MICHAUD, KRISTEN L (RN, MSN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 LAFAYETTE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8864
Mailing Address - Country:US
Mailing Address - Phone:661-373-3570
Mailing Address - Fax:855-351-8707
Practice Address - Street 1:1950 LAFAYETTE RD STE 204
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-8864
Practice Address - Country:US
Practice Address - Phone:661-373-3570
Practice Address - Fax:855-351-8707
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043098-21163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)