Individual
KATE MYSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 LONGWOOD AVE # FEGAN9, BOSTON, MA 02115-5724
(617) 355-7970
Mailing address
300 LONGWOOD AVE # FEGAN9, BOSTON, MA 02115-5724
(176) 355-7970
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
R186811
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2320642
MA
Other
Enumeration date
08/11/2015
Last updated
12/04/2020
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