Healthcare Provider Details

I. General information

NPI: 1467968693
Provider Name (Legal Business Name): CATHERINE E. HERMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 12/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 VARNUM AVE 204
LOWELL MA
01854-2141
US

IV. Provider business mailing address

29 DENNETT RD
MARBLEHEAD MA
01945-3712
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-1666
  • Fax: 978-452-1780
Mailing address:
  • Phone: 781-690-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2307125
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: