| NPI | 1053599100 |
|---|---|
| Former Name | KRISTEN M. BOURQUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN262748) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN262748) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2020-10-27 |