Provider Demographics
NPI:1194487082
Name:WINSLOW, KATIE MARIE (FNP BC, RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MARIE
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:FNP BC, RN, MSN
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:BISSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 CARA LN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1769
Mailing Address - Country:US
Mailing Address - Phone:413-374-9184
Mailing Address - Fax:
Practice Address - Street 1:38 MULBERRY ST STE 204
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-5339
Practice Address - Country:US
Practice Address - Phone:413-727-3882
Practice Address - Fax:413-727-3140
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN235903363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner