Individual
MS. CATHERINE M MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-1975
(774) 441-9235
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
190859
MA
363LA2200X
Adult Health Nurse Practitioner
190859
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110025173A
—
MA
Enumeration date
05/23/2006
Last updated
03/31/2020
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