Provider Demographics
NPI:1376353698
Name:IGO, KATELYN (FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:IGO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEW CROSSING RD STE 301
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3271
Mailing Address - Country:US
Mailing Address - Phone:781-942-0380
Mailing Address - Fax:
Practice Address - Street 1:30 NEW CROSSING RD STE 301
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3271
Practice Address - Country:US
Practice Address - Phone:781-942-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2326373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily