Provider Demographics
NPI:1013169481
Name:ABERNATHY, KATHLEEN DIEHL (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:DIEHL
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6755
Mailing Address - Country:US
Mailing Address - Phone:207-846-4008
Mailing Address - Fax:
Practice Address - Street 1:261 MAIN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6755
Practice Address - Country:US
Practice Address - Phone:207-846-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME124302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry