Provider Demographics
NPI:1326199597
Name:LIND, KATHRYN ANNE (RNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANNE
Last Name:LIND
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-2509
Mailing Address - Country:US
Mailing Address - Phone:617-471-8063
Mailing Address - Fax:617-471-2610
Practice Address - Street 1:950 WINTER ST
Practice Address - Street 2:SUITE 3800
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1424
Practice Address - Country:US
Practice Address - Phone:781-472-8613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107121363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA107121OtherNURSING LICENSE
MAML03199541OtherCONTROLLED SUBSTANCE REGI
ML0324549OtherDEA