Provider Demographics
NPI:1437562261
Name:ARENA, KATELYN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:ARENA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 ACCORD PARK DR STE D4
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1652
Mailing Address - Country:US
Mailing Address - Phone:781-952-1526
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1889
Practice Address - Country:US
Practice Address - Phone:781-952-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2260401163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse