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Individual

MRS. KATHLEEN E FORTINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
51 MILL ST, BUILDING E #17, HANOVER, MA 02339-1641
(781) 826-2131
(781) 826-4513
Mailing address
51 MILL ST, BUILDING E #17, HANOVER, MA 02339-1641
(781) 826-2131
(781) 826-4513

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
154202
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0390330
MA
01
NP2408
BCBS
MA
Enumeration date
11/03/2005
Last updated
05/11/2012
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