Provider Demographics
NPI:1336985068
Name:CARMAN, KRISTEN ANNE (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ANNE
Last Name:CARMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1797 VETERANS MEMORIAL HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1537
Mailing Address - Country:US
Mailing Address - Phone:631-804-9403
Mailing Address - Fax:
Practice Address - Street 1:1797 VETERANS MEMORIAL HWY STE 2
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1537
Practice Address - Country:US
Practice Address - Phone:631-804-9403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406059363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health