Doctor Name: | MRS. KATHLEEN E FORTINI |
NPI Number: | 1023009495 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PNP |
License Number: | 154202 |
Business Practice Address: | 51 Mill St Building E #17 Hanover, MA - 023391641 |
Business Phone Number: | 7818262131 |
Business Fax Number: | 7818264513 |
Mailing Address: | 51 Mill St, Building E #17 HANOVER |
State: | MA |
Postal Code: | 023391641 |
Phone Number: | 7818262131 |
Fax Number: | 7818264513 |
NPI Enumeration Date: | 11/03/2005 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 154202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |