Provider Demographics
NPI:1013650795
Name:RICHER, KATELYN A (CNM)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:A
Last Name:RICHER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ORNAC
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3317
Mailing Address - Country:US
Mailing Address - Phone:978-369-7627
Mailing Address - Fax:
Practice Address - Street 1:59 ORNAC
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3317
Practice Address - Country:US
Practice Address - Phone:978-369-7627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2024-10-18
Deactivation Date:2024-10-08
Deactivation Code:
Reactivation Date:2024-10-17
Provider Licenses
StateLicense IDTaxonomies
CA236246367A00000X
MARN10003018367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife