Individual
MS. KATHLEEN SARAH JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(314) 454-6093
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2005004092
MO
363LP0200X
Pediatric Nurse Practitioner
2005004092
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
RN191241
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568883734
—
MO
05
—
ENROLLED
—
IL
Enumeration date
12/13/2013
Last updated
02/05/2020
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