Healthcare Provider Details

I. General information

NPI: 1194329052
Provider Name (Legal Business Name): KATHERINE ELIZABETH PERRONE WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 OLD ROAD TO 9 ACRE COR
CONCORD MA
01742-4169
US

IV. Provider business mailing address

32 CARNEY ST
MEDFORD MA
02155-2802
US

V. Phone/Fax

Practice location:
  • Phone: 978-369-1400
  • Fax:
Mailing address:
  • Phone: 978-846-4396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberRN2310323
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN2310323
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: