Provider Demographics
NPI:1134313786
Name:MARSON, KATHLEEN ELIZABETH (PNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:MARSON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:750 WASHINGTON ST
Mailing Address - Street 2:TUFTS-NEW ENGLAND MEDICAL CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1526
Mailing Address - Country:US
Mailing Address - Phone:617-636-5535
Mailing Address - Fax:617-636-7738
Practice Address - Street 1:750 WASHINGTON ST
Practice Address - Street 2:TUFTS-NEW ENGLAND MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-5535
Practice Address - Fax:617-636-7738
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156538363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics