Individual
KATHRYN REZUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
409 W BROADWAY, BOSTON, MA 02127-2245
(617) 269-7500
Mailing address
960 MASSACHUSETTS AVE, FLR 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN2301139
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2301139
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110205004A
—
MA
Enumeration date
03/01/2022
Last updated
03/10/2026
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