MEDICARE: KATHRYN KORTE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	138759	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NP0624	OTHER	MA	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043211956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN KORTE FNP

Provider Business Mailing Address
First Line	:	PO BOX 30
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230
Country	:	US
Telephone Number	:	413-528-9311
Fax Number	:	413-644-0274

Provider Business Practice Location Address
First Line	:	444 STOCKBRIDGE ROAD
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230
Country	:	US
Telephone Number	:	413-528-8580
Fax Number	:	413-644-0274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/21/2022

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