Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 254981 | MA |
NPI | 1003027574 |
---|---|
Provider Name | Kristen Cahill |
First Address | Jamaica Plain, MA 02130-2732 |
Second Address | Wellesley, MA 02481-8268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |