MEDICARE: MS. KATHLEEN ROSE GOLDEN MCANDREW MSN, APRN, BC, ANP

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
1	363LA2200X	Adult Health Nurse Practitioner	208056	MA

General Provider Information

NPI Number	:	1689658205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ROSE GOLDEN MCANDREW MSN, APRN, BC, ANP

Provider Business Mailing Address
First Line	:	42 8TH ST
Second Line	:	SUITE 5313
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-4207
Country	:	US
Telephone Number	:	617-201-6407
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MORRISSEY BLVD
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02125-3393
Country	:	US
Telephone Number	:	617-287-5666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/08/2007

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