Basic Information
| Provider Information | |||||||||
| NPI: | 1770250193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTH | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 HIGH ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | NORTH ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018452662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782584734 | ||||||||
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| Practice Location | |||||||||
| Address1: | 172 MIDDLESEX AVE | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018872737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786584432 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2021 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN2309707 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.