Provider Demographics
NPI:1447380555
Name:HOGAN-SOLTYS, KATHLEEN E (APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:HOGAN-SOLTYS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23.5 MOUNTAIN VIEW DR.
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082
Mailing Address - Country:US
Mailing Address - Phone:413-967-5585
Mailing Address - Fax:
Practice Address - Street 1:263 ALDEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3707
Practice Address - Country:US
Practice Address - Phone:413-748-3175
Practice Address - Fax:413-748-3444
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204983363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3260OtherBLUE CROSS
MANP3260Medicare ID - Type Unspecified
MAP31386Medicare UPIN