Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 154743 | MA |
NPI | 1417159898 |
---|---|
Provider Name | Kathryn Kochan |
First Address | Chestnut Hill, MA 02467-1436 |
Second Address | Roxbury, MA 02119-1208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 19/02/2020 |