Provider Demographics
NPI:1245897263
Name:GENETTI, KATHLEEN E (APRN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:GENETTI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERRILL DRIVE INDUSTRIAL BUILDING E
Mailing Address - Street 2:ST 26
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842
Mailing Address - Country:US
Mailing Address - Phone:603-783-1087
Mailing Address - Fax:
Practice Address - Street 1:1 MERRILL DR INDUSTRIAL BUILDING E
Practice Address - Street 2:ST 26
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842
Practice Address - Country:US
Practice Address - Phone:603-783-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2275105363LF0000X
NH067449-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily