Provider Demographics
NPI:1609873843
Name:WESTALL, KATHRYN N (RNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:N
Last Name:WESTALL
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SOUTHWEST AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02835-1120
Mailing Address - Country:US
Mailing Address - Phone:401-423-2616
Mailing Address - Fax:401-423-3485
Practice Address - Street 1:20 SOUTHWEST AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02835-1120
Practice Address - Country:US
Practice Address - Phone:401-423-2616
Practice Address - Fax:401-423-3485
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP17587363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26464OtherRI BC/BS
RI7004608Medicaid
RI409241OtherRI BLUE CHIP
RI7004608Medicaid
007004630Medicare ID - Type Unspecified