Healthcare Provider Details

I. General information

NPI: 1124939822
Provider Name (Legal Business Name): ANNETTE GATAKAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ERDMAN WAY
LEOMINSTER MA
01453-1804
US

IV. Provider business mailing address

8 ATWOOD DR STE 301
NORTHAMPTON MA
01060-4266
US

V. Phone/Fax

Practice location:
  • Phone: 413-773-1314
  • Fax:
Mailing address:
  • Phone: 413-773-1314
  • Fax: 413-774-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN2386189
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: