Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN2291915 | MA |
NPI | 1033604228 |
---|---|
Provider Name | Kate Renee Sciacca |
First Address | Boston, MA 02114-3260 |
Second Address | Boston, MA 02215-5450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2018 |
Last Update Date | 29/06/2018 |