Provider Demographics
NPI:1033293725
Name:SYLVESTER, KATHLEEN M (NP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:234 RUSSELL ST STE 7
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3534
Mailing Address - Country:US
Mailing Address - Phone:413-586-6020
Mailing Address - Fax:413-584-0286
Practice Address - Street 1:234 RUSSELL ST STE 7
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-586-6020
Practice Address - Fax:413-584-0286
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142872363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACHNP2171Medicare ID - Type Unspecified
MAS96960Medicare UPIN