Provider Demographics
NPI:1215474077
Name:HURLEY, KATHRYN MARY (PNP-PC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARY
Last Name:HURLEY
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARY
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP-PC
Mailing Address - Street 1:300 FIRST AVE
Mailing Address - Street 2:8TH FLOOR PEDIATRICS
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129
Mailing Address - Country:US
Mailing Address - Phone:617-952-5800
Mailing Address - Fax:617-952-5968
Practice Address - Street 1:300 FIRST AVE
Practice Address - Street 2:8TH FLOOR PEDIATRICS
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129
Practice Address - Country:US
Practice Address - Phone:617-952-5800
Practice Address - Fax:617-952-5968
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270489363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics