Provider Demographics
NPI:1780324202
Name:KYOTOWADDE, JULIET M (APRN-BC)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:M
Last Name:KYOTOWADDE
Suffix:
Gender:
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TECHNOLOGY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2441
Mailing Address - Country:US
Mailing Address - Phone:978-677-6354
Mailing Address - Fax:
Practice Address - Street 1:7 TECHNOLOGY DR STE 102
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2441
Practice Address - Country:US
Practice Address - Phone:978-677-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2267368363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health