Individual
KATHERINE L. VAN ZANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2264732
MA
363L00000X
Nurse Practitioner
Primary
RN2264732
MA
363LA2100X
Acute Care Nurse Practitioner
RN2264732
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110104568A
—
MA
Enumeration date
05/07/2014
Last updated
11/30/2020
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