Provider Demographics
NPI:1891431771
Name:SOBKOWICH, KIRSTEN PIOTROWSKI (APRN)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:PIOTROWSKI
Last Name:SOBKOWICH
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 1:100 BOSTON RD STE E
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1879
Mailing Address - Country:US
Mailing Address - Phone:978-448-4300
Mailing Address - Fax:978-448-4040
Practice Address - Street 1:100 BOSTON RD STE E
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1879
Practice Address - Country:US
Practice Address - Phone:978-448-4300
Practice Address - Fax:978-448-4040
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2368610363L00000X
NH075151-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner