Provider Demographics
NPI:1316829815
Name:DARRELL, KATHARINE ALLYN (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ALLYN
Last Name:DARRELL
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EARHART ST UNIT 1004
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1964
Mailing Address - Country:US
Mailing Address - Phone:207-233-9055
Mailing Address - Fax:
Practice Address - Street 1:2 EARHART ST UNIT 1004
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1964
Practice Address - Country:US
Practice Address - Phone:207-233-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2364860163WC0200X
MERN67004163WC0200X
MA153753367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine