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NPI Code Detail

MEDICARE: KATHRYN JOAN HOLLETT

MEDICARE:   KATHRYN JOAN HOLLETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician79788MA

General Provider Information

NPI Number : 1619965654
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN JOAN HOLLETT
Provider Business Mailing Address
First Line : 73D WINTHROP AVE
Second Line : PLAZA 114
City : LAWRENCE
State : MA
Zip : 01843-3716
Country : US
Telephone Number : 978-686-3017
Fax Number : 978-685-4280
Provider Business Practice Location Address
First Line : LAHEY HEALTH PRIMARY CARE, GLOUCESTER
Second Line : 298 WASHINGTON STREET
City : GLOUCESTER
State : MA
Zip : 01930
Country : US
Telephone Number : 978-283-2726
Fax Number : 978-283-0840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 07/30/2018

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Directions to “ KATHRYN JOAN HOLLETT ” Practice Location

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