Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 176797 | MA |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 201407057NP-PP | OR |
NPI | 1760685739 |
---|---|
Provider Name | Suzanne Kavet |
First Address | Portland, OR 97239-4571 |
Second Address | Boston, MA 02210-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 06/11/2014 |