Provider Demographics
NPI:1689742074
Name:BALDOR, KATHRYN R (APRN BC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:R
Last Name:BALDOR
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16 WYMAN RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1601
Mailing Address - Country:US
Mailing Address - Phone:978-874-6427
Mailing Address - Fax:
Practice Address - Street 1:16 WYMAN RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1601
Practice Address - Country:US
Practice Address - Phone:978-874-6427
Practice Address - Fax:508-829-2905
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0138831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health