Provider Demographics
NPI:1164884722
Name:PRITCHARD, KIMBERLY (CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6007
Mailing Address - Country:US
Mailing Address - Phone:857-307-0896
Mailing Address - Fax:857-307-0899
Practice Address - Street 1:185 PILGRIM RD
Practice Address - Street 2:BAKER 304
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-632-7270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN232440363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care