Individual
KATHRYN JEAN POTENZONE-CHIARIELLO I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-1814
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
(833) 933-1106
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2306212
MA
363LG0600X
Gerontology Nurse Practitioner
AG07190141
MA
Other
Enumeration date
07/16/2019
Last updated
12/04/2022
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