Individual
KATELYN JEANNE LARACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
300 LONGWOOD AVE, DEPARTMENT OF NEUROLOGY FEGAN 11, BOSTON, MA 02115-5724
(617) 355-6388
(617) 730-0284
Mailing address
300 LONGWOOD AVE, DEPARTMENT OF NEUROLOGY FEGAN 11, BOSTON, MA 02115-5724
(617) 355-6388
(617) 730-0284
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN264377
MA
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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