Wailgum, Kristine K

Wailgum, Kristine K is an individual health care provider with primary practice located at 770 Converse St , Longmeadow MA 01106-1719. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Wailgum, Kristine K can be contacted via phone (413) 567-3949.

Contact Information

Primary practice address
770 Converse St Longmeadow MA 01106-1719
Phone: (413) 567-3949
Fax: (413) 567-0175
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 110009 Massachusetts

Profile Details

NPI number 1477524031
LBN Legal business name Wailgum, Kristine K
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Oct 25th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477524031 NPPES
Massachusetts Other 8303930 EVERCARE
Massachusetts MEDICAID 0710296 EVERCARE
Massachusetts Other NP2697 EVERCARE

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