Kimberly A Bautista, RN
Nurse Practitioner, Family in Boston, MA. Individual provider (NPI-1).
NPI number1598355307
StatusActive
Last updated in NPPESMar 17, 2023
Details
- NPI
- 1598355307
- Entity type
- Individual (NPI-1)
- Name
- Kimberly A Bautista
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 25, 2021
- Certification date
- Mar 17, 2023
- Last updated
- Mar 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN2311024 | MA | Yes |
| 163WC0400X | Registered Nurse, Case Management | RN2311024 | MA |
Practice location
801 Massachusetts Ave, Suite 6cBoston, MA 02118
Phone 617-414-5951 · Fax 617-414-9201
Mailing address
960 Massachusetts AveBoston, MA 02118-2620
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