Provider Demographics
NPI:1174815013
Name:BUCCI, KATHERINE M (RN, MPH, CDOE)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:M
Last Name:BUCCI
Suffix:
Gender:F
Credentials:RN, MPH, CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 WATERMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2427
Mailing Address - Country:US
Mailing Address - Phone:401-595-5313
Mailing Address - Fax:401-435-7803
Practice Address - Street 1:104 DEXTER SAUNDERS RD
Practice Address - Street 2:
Practice Address - City:GLOCESTER
Practice Address - State:RI
Practice Address - Zip Code:02857-2600
Practice Address - Country:US
Practice Address - Phone:401-595-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN18144163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator