Provider Demographics
NPI:1477127322
Name:ZOMBECK, KATHERINE (RN, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:ZOMBECK
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:NAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:480 EDMANDS RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3009
Mailing Address - Country:US
Mailing Address - Phone:818-292-6603
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5491
Practice Address - Country:US
Practice Address - Phone:617-667-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-16
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2313416163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse