Provider Demographics
NPI:1225206824
Name:CAIL, KATHERINE M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:M
Last Name:CAIL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:TENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:248 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-230-7266
Mailing Address - Fax:603-227-7554
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-230-7266
Practice Address - Fax:603-227-7554
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH058740-23363LW0102X
NH058740-21363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1225206824Medicaid
NH1225206824Medicaid
NH000515101Medicare PIN