Healthcare Provider Details

I. General information

NPI: 1619688819
Provider Name (Legal Business Name): KATHLEEN RUTH HOOD NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHLEEN RUTH MULLINS

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 MAIN ST
BUZZARDS BAY MA
02532-3229
US

IV. Provider business mailing address

243 MAIN ST
BUZZARDS BAY MA
02532-3229
US

V. Phone/Fax

Practice location:
  • Phone: 508-743-5542
  • Fax:
Mailing address:
  • Phone: 508-594-3354
  • Fax: 508-979-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2265939
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: