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Individual

KATHERINE PACHECO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
110 LIBERTY ST, BROCKTON, MA 02301
(508) 894-0400
(508) 894-0617
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5521
(508) 894-0400
(508) 894-0617

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
214357
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
UX9190
MEDICARE PTAN
MA
Enumeration date
06/27/2006
Last updated
02/21/2019
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