Healthcare Provider Details

I. General information

NPI: 1669810974
Provider Name (Legal Business Name): KATELYNN SOCHA MSN, RN/NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2013
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEEHAN LN
CUMBERLAND RI
02864-1413
US

IV. Provider business mailing address

2 MEEHAN LN
CUMBERLAND RI
02864-1413
US

V. Phone/Fax

Practice location:
  • Phone: 401-658-2525
  • Fax:
Mailing address:
  • Phone: 401-658-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2286703
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN50761
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN/NP2286073
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCAPRN01299
License Number StateRI
# 5
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN01299
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: