Healthcare Provider Details

I. General information

NPI: 1841809704
Provider Name (Legal Business Name): MARYKATE DURETTE-PICCIRILLO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY-KATE DURETTE-PICCIRILLO CNM

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 PURCHASE ST
NEW BEDFORD MA
02740-6232
US

IV. Provider business mailing address

874 PURCHASE ST
NEW BEDFORD MA
02740-6232
US

V. Phone/Fax

Practice location:
  • Phone: 508-992-6553
  • Fax:
Mailing address:
  • Phone: 508-992-6553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP61239386
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN10029522
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN10029522
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: