Individual
MS. KATHLEEN ELIZABETH ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-8817
(617) 421-8818
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-8817
(617) 421-8818
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
120744
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
120744
MA
363LA2200X
Adult Health Nurse Practitioner
NP15446
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356671
—
MA
01
—
31695-2
BCBSRI
RI
01
—
413606
BLUE CHIP
RI
01
—
AA91036
HPHC
MA
01
—
NP1987
BCBS
MA
Enumeration date
07/14/2006
Last updated
06/11/2014
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