Healthcare Provider Details

I. General information

NPI: 1285695809
Provider Name (Legal Business Name): KATHERINE LOUISE FERNALD MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 UNION ST SUITE 107
NATICK MA
01760-7700
US

IV. Provider business mailing address

25 MAIN ST SUITE 7
WAYLAND MA
01778-5036
US

V. Phone/Fax

Practice location:
  • Phone: 508-655-8727
  • Fax: 508-655-1270
Mailing address:
  • Phone: 617-686-3332
  • Fax: 508-655-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number928
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number928
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number928
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: