Provider Demographics
NPI:1114401791
Name:KINGSTON, CATHERINE (AANP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:AANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BARDERRY LN
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03290-4900
Mailing Address - Country:US
Mailing Address - Phone:603-361-9106
Mailing Address - Fax:
Practice Address - Street 1:1 LITTLE RIVER RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-3117
Practice Address - Country:US
Practice Address - Phone:603-347-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH053595-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty