Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN234628 | MA |
NPI | 1043552052 |
---|---|
Provider Name | Kateri Egan Mcguinness |
First Address | Charlestown, MA 02129-1615 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 16/02/2017 |