Provider Demographics
NPI:1518195635
Name:WALSH, KATHRYN S (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:S
Last Name:WALSH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COTTAGE HOSPITAL
Mailing Address - Street 2:90 SWIFTWATER ROAD
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785
Mailing Address - Country:US
Mailing Address - Phone:603-747-9000
Mailing Address - Fax:603-747-3310
Practice Address - Street 1:COTTAGE HOSPITAL
Practice Address - Street 2:90 SWIFTWATER ROAD
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785
Practice Address - Country:US
Practice Address - Phone:603-747-9000
Practice Address - Fax:603-747-3310
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0114867367500000X
PARN530087L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1024431Medicaid
NH3100133Medicaid