Provider Demographics
NPI:1952468969
Name:HOWARD, KATHERINE YOUNG (NP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:YOUNG
Last Name:HOWARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BATES ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2805
Mailing Address - Country:US
Mailing Address - Phone:508-369-7984
Mailing Address - Fax:
Practice Address - Street 1:475 KILVERT ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1379
Practice Address - Country:US
Practice Address - Phone:401-290-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207381363LG0600X
RINPP37323363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM990903Medicaid
MAYO NP2992Medicare ID - Type Unspecified
MAS40439Medicare UPIN