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General NPI Number Information
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NPI Number | 1447719976
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Entity Type | Individual
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Provider Name | RENEE CATJAKIS
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Gender | Female
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 233 CAREW ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-2377
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Country | US
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Telephone | 413-748-6870
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Fax |
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Provider Business Mailing Address
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Address Line | 4 YALE CT
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City | ENFIELD
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State | CT
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Zip | 06082-5521
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Country | US
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Telephone | 413-896-4875
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN2301062
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 8475
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | RN2301062
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License Number State | MA
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