Provider Demographics
NPI:1447552203
Name:TOPHAM HOMZE, KRISTIN L (MSN, RNNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:L
Last Name:TOPHAM HOMZE
Suffix:
Gender:F
Credentials:MSN, RNNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-469-5445
Mailing Address - Fax:
Practice Address - Street 1:1 PARK WAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-469-5445
Practice Address - Fax:978-469-5485
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN239778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily