Provider Demographics
NPI:1871707414
Name:KING, KATHERINE MAUREEN
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAUREEN
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:MAUREEN
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:16 VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:RI
Mailing Address - Zip Code:02829
Mailing Address - Country:US
Mailing Address - Phone:401-949-0765
Mailing Address - Fax:
Practice Address - Street 1:1150 DOUGLAS PIKE
Practice Address - Street 2:BRYANT UNIVERSITY
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1291
Practice Address - Country:US
Practice Address - Phone:401-232-6220
Practice Address - Fax:401-232-6702
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP17307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily