Basic Information
| Provider Information | |||||||||
| NPI: | 1730633108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAST | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | BETINA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | KAST | ||||||||
| OtherFirstName: | LORI | ||||||||
| OtherMiddleName: | BETINA | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 243 ELM STREET | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035697500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 243 ELM STREET | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035697500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2016 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LC0200X | 048579-23 | NH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine | 363LF0000X | 048579-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.