Individual
KIM M TREMBLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
30 NORTHAMPTON ST, BOSTON, MA 02118-4098
(617) 433-9601
(617) 445-6538
Mailing address
354 MERRIMACK ST, LAWRENCE, MA 01843-1754
(978) 687-2321
(978) 685-7265
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
036506-21
NH
363L00000X
Nurse Practitioner
147292
MA
363LF0000X
Family Nurse Practitioner
147292
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
147292
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP0790
BCBSMA
MA
Enumeration date
10/04/2005
Last updated
01/24/2020
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