Individual
KATHLEEN WATERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
120 BEACON ST, HOUSE CALL PROGRAM, SOMERVILLE, MA 02143-4370
(617) 499-8358
Mailing address
120 BEACON ST, HOUSE CALL PROGRAM, SOMERVILLE, MA 02143-4370
(617) 499-8358
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
151684
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP5210
BCBS MA
MA
Enumeration date
04/16/2007
Last updated
07/08/2007
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