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General NPI Number Information
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NPI Number | 1164069670
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Entity Type | Individual
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Provider Name | CATHY MAXI NP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 130 WATER ST
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City | FITCHBURG
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State | MA
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Zip | 01420-5478
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Country | US
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Telephone | 978-878-8300
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Fax | 978-627-8349
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Provider Business Mailing Address
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Address Line | 130 WATER ST
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City | FITCHBURG
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State | MA
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Zip | 01420-5747
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Country | US
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Telephone | 978-878-8100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2290081
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2290081
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License Number State | MA
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