Provider Demographics
NPI:1568228328
Name:RUUSUKALLIO, KATELYNN MARIE (RN, BSN, MSN)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:MARIE
Last Name:RUUSUKALLIO
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:MS
Other - First Name:KATELYNN
Other - Middle Name:MARIE
Other - Last Name:RUUSUKALLIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:692 W HOUSATONIC ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6621
Mailing Address - Country:US
Mailing Address - Phone:413-358-3135
Mailing Address - Fax:
Practice Address - Street 1:692 W HOUSATONIC ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6621
Practice Address - Country:US
Practice Address - Phone:413-358-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2358311163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health