=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033293725
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHLEEN M SYLVESTER NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2006
-----------------------------------------------------
Last Update Date | 05/01/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 234 RUSSELL ST STE 7
-----------------------------------------------------
City | HADLEY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01035-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-586-6020
-----------------------------------------------------
Fax | 413-584-0286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 234 RUSSELL ST STE 7
-----------------------------------------------------
City | HADLEY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01035-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-586-6020
-----------------------------------------------------
Fax | 413-584-0286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 142872
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------