Provider Demographics
NPI:1093415119
Name:PLACER, KATHRYN FRANCES
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:FRANCES
Last Name:PLACER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SAVIN HILL AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1055
Mailing Address - Country:US
Mailing Address - Phone:415-810-9571
Mailing Address - Fax:
Practice Address - Street 1:333 SAVIN HILL AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-1055
Practice Address - Country:US
Practice Address - Phone:415-810-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty