Provider Demographics
NPI:1013908235
Name:PRATT, KATHLEEN ANN (MSPT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:PRATT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187A HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-3125
Mailing Address - Country:US
Mailing Address - Phone:603-772-0708
Mailing Address - Fax:603-772-3491
Practice Address - Street 1:187A HIGH ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-3125
Practice Address - Country:US
Practice Address - Phone:603-772-0708
Practice Address - Fax:603-772-3491
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1657225100000X
MA9285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH5262126OtherAETNA PROVIDER NUMBER
NH5909607OtherCIGNA PROVIDER #
NH0809777Y0NH01OtherANTHEM BCBS PROVIDER #
NHAA26635OtherHARVARD PILGRIM PROVIDER
NHAA26635OtherHARVARD PILGRIM PROVIDER