Provider Demographics
NPI:1447303912
Name:GIANELIS, KRISTIN A (DNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:A
Last Name:GIANELIS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:ANN
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:51 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4869
Mailing Address - Country:US
Mailing Address - Phone:401-343-0058
Mailing Address - Fax:
Practice Address - Street 1:51 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-4869
Practice Address - Country:US
Practice Address - Phone:401-343-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258386363L00000X
RIAPRN00755363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0711306Medicaid
132525OtherFALLON
042297845OtherHCVM/FIRST HEALTH/COVENTY
042297845OtherPHCS/MULTI-PLAN
042297845OtherTRICARE
NP560501OtherMEDICARE
SS0046OtherBCBSMA
132525OtherFALLON