Provider Demographics
NPI:1932244753
Name:KHANNA, KRISTEN LYNN (APRN-BC, ANP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYNN
Last Name:KHANNA
Suffix:
Gender:F
Credentials:APRN-BC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:95 STILES RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4805
Mailing Address - Country:US
Mailing Address - Phone:603-952-4804
Mailing Address - Fax:603-952-4806
Practice Address - Street 1:95 STILES RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4805
Practice Address - Country:US
Practice Address - Phone:603-952-4804
Practice Address - Fax:603-952-4806
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH05735023363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health