Provider Demographics
NPI:1629354170
Name:PINETTE, KENNETH ANTHONY (NP)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:ANTHONY
Last Name:PINETTE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HAVERHILL RD.
Mailing Address - Street 2:SUITE 395
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913
Mailing Address - Country:US
Mailing Address - Phone:978-388-1456
Mailing Address - Fax:978-388-1269
Practice Address - Street 1:110 HAVERHILL RD.
Practice Address - Street 2:SUITE 395
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913
Practice Address - Country:US
Practice Address - Phone:978-388-1456
Practice Address - Fax:978-388-1269
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN264030363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health