Provider Demographics
NPI:1184960536
Name:CHARLAND, KATHERINE
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:CHARLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-3960
Mailing Address - Country:US
Mailing Address - Phone:207-323-5439
Mailing Address - Fax:
Practice Address - Street 1:12 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:SEARSPORT
Practice Address - State:ME
Practice Address - Zip Code:04974-3960
Practice Address - Country:US
Practice Address - Phone:207-323-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker