Healthcare Provider Details

I. General information

NPI: 1700028917
Provider Name (Legal Business Name): KATHRYN PATRICIA ARSENAULT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N. MAIN ST
WEST BROOKFIELD MA
01585
US

IV. Provider business mailing address

46 N. MAIN ST
WEST BROOKFIELD MA
01585
US

V. Phone/Fax

Practice location:
  • Phone: 508-867-8977
  • Fax: 508-867-7361
Mailing address:
  • Phone: 508-867-8977
  • Fax: 508-867-7361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number183064
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: