Individual
KATHRYN A PROULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, PH.D.
Contact information
Practice address
1049 MAIN ST, SPRINGFIELD, MA 01103-2114
(413) 739-1100
(413) 304-4666
Mailing address
1049 MAIN ST, SPRINGFIELD, MA 01103-2114
(413) 739-1100
(413) 304-4666
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
127180
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
001162
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110028120
—
MA
Enumeration date
11/02/2006
Last updated
12/16/2016
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