Provider Demographics
NPI:1629370309
Name:KNOWLTON, KATHLEEN L (GNP-BS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:L
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:GNP-BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 OLD RIVER RD.
Mailing Address - Street 2:STE 108
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1397
Mailing Address - Country:US
Mailing Address - Phone:401-723-9250
Mailing Address - Fax:814-339-6165
Practice Address - Street 1:132 OLD RIVER RD.
Practice Address - Street 2:STE 108
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1397
Practice Address - Country:US
Practice Address - Phone:401-723-9250
Practice Address - Fax:814-339-6165
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01381363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology