Provider Demographics
NPI:1497351779
Name:SERVICE, KATHRYN FRANCES (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:FRANCES
Last Name:SERVICE
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:FRANCES
Other - Last Name:PEKALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9 BUTLER PL
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3307
Mailing Address - Country:US
Mailing Address - Phone:413-695-9633
Mailing Address - Fax:
Practice Address - Street 1:9 BUTLER PL
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3307
Practice Address - Country:US
Practice Address - Phone:413-695-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119175163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse