Healthcare Provider Details

I. General information

NPI: 1710512074
Provider Name (Legal Business Name): KATHERINE MCKEMMIE QUINN MSN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

550 LIBERTY ST APT 1308
BRAINTREE MA
02184-7378
US

V. Phone/Fax

Practice location:
  • Phone: 413-575-0108
  • Fax:
Mailing address:
  • Phone: 413-575-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2330309
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN2330309
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: