Doctor Name: | KATHLEEN AMMON |
NPI Number: | 1104282136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN2278892 |
Business Practice Address: | 109 Commercial St Malden, MA - 021485509 |
Business Phone Number: | 7813884160 |
Business Fax Number: | 7813978715 |
Mailing Address: | 109 Commercial St, MALDEN |
State: | MA |
Postal Code: | 021485509 |
Phone Number: | 7813884160 |
Fax Number: | 7813978715 |
NPI Enumeration Date: | 01/06/2016 |
NPI Last Update Date: | 01/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | RN2278892 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |